Date Received: August 8, 2002

The author(s) shown below used Federal funds provided by the U.S.
Department of Justice and prepared the following final report:
Document Title: Process Evaluation Assessing the Gender

Appropriateness of the KEY/CREST Program,
Final Report
Author(s): Delaware Criminal Justice Council
Document No.: 195788
Date Received: August 8, 2002
Award Number: 1999-RT-VX-K016
This report has not been published by the U.S. Department of Justice.
To provide better customer service, NCJRS has made this Federally-
funded grant final report available electronically in addition to
traditional paper copies.
Opinions or points of view expressed are those

of the author(s) and do not necessarily reflect
the official position or policies of the U.S.
Department of Justice.
PROCESS EVALUATION ASSESSING THE GENDER
APPROPRIATENESS OF THE KEY / CREST PROGRAM
FINAL REPORT TO THE
NATIONAL INSTITUTE OF JUSTICE
1999 - RT - VX - KO16
SUBMITTED BY THE
DELAWARE CRIMINAL JUSTICE COUNCIL
(April 2002)
This document is a research report submitted to the U.S. Department of Justice. This report has not
been published by the Department. Opinions or points of view expressed are those of the author(s)
and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
a Acknowledgments
This report is the result of various people who have contributed to the goal of assessing
whether the KEY / CREST program at Baylor Women’s Correctional Institution is appropriate
for drug treatment services for female inmates.
The following staff was responsible for the research conducted for this report:
Arthur H. Garrison
Principal Investigator / Project Director
Delaware Criminal Justice Council
Alison Rose
Researcher / Lead Interviewer
Wendy Rosenbauer
Interviewer
Dorothy Lockwood - Dillard, Ph.D.

consultant
Beth Haslett, Ph.D.

consultant
This report was written by:
Arthur H. Garrison
Principal Investigator / Project Director
This project was supported by grant No. 1999 - RT - VX - KO16 awarded by the National
Institute of Justice, Office of Justice Programs, U.S. Department of Justice. The National Institute
of Justice is a component of the Office of Justice Programs, which also includes the Bureau of
Justice Statistics, the Bureau of Justice Assistance, the Office Juvenile Justice and Delinquency
Prevention, and the Office of Victims of Crime. Points of view or opinions in this document are
those of the author and do not necessarily represent the official position or policies of the United
a States Department of Justice.
Table of Contents
0
Executive Summary ....................................................................................................................... 4
Literature R e ~ e ..........................................................................................................................
w 9
Program
. . .............................................................................................................................
Desc~pfion 18
Scope and Methodology............................................................................................................... 23
Detailed Findings.......................................................................................................................... 26
Part One: Assess recent graduates of Baylor as a basis to create a profile
Of program participants and secure background data for survey / interview
Questions.............................................................................................. 26
Part Two: Curn'culumReview...................................................................... 31
Part Three: Assess Client SatisfBction............................................................. 38
Part Four: Focus Group Analysis................................................................... 41
Baylor Women's Correctional Institute................................................... 42
CRESTNOrth................................................................................. 43
CREST South................................................................................. 47
Analysis and Discussion ............................................................................................................... 49

Preliminary Draft Recommendations........................................................................................ 56
Endnotes...................................................................................................................................... 57
Appendix................................................................................................................................... Tab
Appendix One: Rose. A . (2000). 1999 DISCHARGED POPULATION OF THE KEY
VILLAGE DRUG TREATMENT PROGRAM: BAYLOR WOMEN'S
CORRECTIONAL INSTITUTE-PRELIMINARYDATA ANALYSIS.............................. 1
Appendix Two: Haslett. B.(2001).EVALUATION OF THE GENDER

APPROPRIATENESS OF THE FEMALE OFFENDER'S
SUBSTANCE ABUSE PROGRAM.................................................................................... 2
Appendix Three: BAYLOR INTERVIEW SURVEY AND IRB

PROTOCOLS ............................................................................................ 3
a Executive Summary
Introduction
The Delaware Criminal Justice Council received a grant fiom the National Institute of
Justice to conduct a process evaluation’ to assess the gender appropriateness of a Therapeutic
Community (TC) model used at the Baylor Women’s Correctional Institute (Baylor) and the I
CREST North and South TC treatment programs. Baylor is a level V women’s prison, CREST i
North is a TC treatment work release program and CREST South is a TC work release program
housed on the campus of the Sussex Correctional Institution (a level V prison). A Level V prison
is one in which the fkcility is secured and prisoners do not have the capacity to leave. Level V
prisons hold people who are sentenced to more than one-year incarceration for the commission of
misdemeanors or felonies.
The evaluation included the use of data analysis on the 1999 KEY program at Baylor,
individual interviews with the women currently participating in the Baylor KEY program,
curriculum analysis and focus groups with the participants in the Baylor, CREST North and
0 CREST South treatment programs. The goals of the research and interviews were:
1. To assess what the participants thought about the program; and
2. To determine ifthe women thought the program met their needs specifically based
on gender.
Background
Drug use leads to many antisocial behaviors including dyshctional families and
criminality. One of the treatment programs that has gained in prominence in treating drug addicts,
while in prison, is the Therapeutic Community Model. Therapeutic communities, in prison
environments, are based on the concept that the addict must be removed fiom the general
1 By process evaluation the author means an evaluation in which the goal is to review the theory and operations of the
program to determine if the program, as implemented and received by the clients of the program, is reaching the desired
goals.
Report to the National Institute of Justice Delaware Criminal Justice Council

Process Evaluation Assessing the Gender Grant Number 99 - RT - VX - KO16
0 Appropriatenessof the KEY / CREST Program
Implemented at the Baylor Women’s Correctional Institute
April 2002 Final Report
Page 4 of 70
e population and placed m a separate area m which the negative iufluences of prison are removed m
order to create an environment that allows for positive behavior change. In a Therapeutic
Colmrmnity Model drug treatment program, drug addiction is viewed as a symptom of the
dysfunctionalbehavior m the addicts’ life and not the cause of the dysfunction m the lifk of the
addict. The addict is considered to be m need of habilitation to positive social behaviors rather
than rehabilitation.
The State of Delaware instituted a Therapeutic Community (KEY) m the Multi-Purpose
criminalJustice Facllity located m Wilrnjngton Delaware m 1988 to treat drug addicts m the
fkcility. In 1994 a similar program was established at the Baylor Women’s Correctional
Institution. Research has shown that the Therapeutic Community model is successll for women
but requires modifications fkom the application of the program to men. Research has also shown
that success of women m Therapeutic Community programs are influenced by various M o r s
including length of stay, the number of participants m the program, history of sexual abuse and the
presence of female counselors and program directors.
During the implementation of the KEY program, it was observed that after care was
needed to continue and maintain the positive changes m a Therapeutic Community KEY graduate.
One of the methods used to meet this need was to establish a work release program based on the
Therputic Community Model. In 1990 Delaware received h d i n g fkom the National Institute
on Drug Abuse to establish the first work release Therapeutic Community (CREST). Research
since the implementation of KEY and CREST has found that addicts who attend KEY and
CREST have lower recidivism rates than those without KEY or CREST program experience.
In 1999, the Delaware Criminal Justice Council received a grant fkom the National
Institute of Justice 0to conduct a process evaluation on the Therapeutic Connnunity program
at the Baylor Correctional Institute and the CREST work release program to assess whether the
treatment contmuum is gender appropriate and to make recommendations to the programs
regarding necessary improvements. This report is the final draft a report to NIJ assessing the
gender appropriateness of the KEY / CREST programs.

Page 5 of 70
e Methodology
The evaluation was divided into four parts:
Part One: Assess recent graduates of Baylor as a basis to create a profile of

program participants and secure background data for survey /
interview questions.
Part Two: C u r r i c b review.

Part Three: Assess client satisiktion.
Part Four: Focus group analysis.
The goal of part one was to determine drop out points along the continuum of the
treatment model. The goal of part two was to assess if the program as designed and implemented
is gender specific and gender appropriate. The goal of part three was to assess what participants
thought about the program and the treatment model. The goal of part four was to provide an
opportunity for open discussion on the gender appropriateness of the program and to discuss the
concepts behind the models as well as gain insight into concerns of program participants.
Summary of hdings
The analysis of the women who were discharged fiom Baylor m 1999 provided a profde
and template for survey and interview questions that were developed for the women who are
currently m Baylor. The profile of the typical participant in the TC program is a woman who is
Caucasian or African American, with less than a high school education, between the age of 31 and
50 years old. She has children and has suffered some level of abuse m her past. Although she
does not have a formal psychiatric treatment history or diagnosis, she has suffered depression,
anxiety andor an inability to concentrate. She may have entertained thoughts of suicide or has
attempted suicide. She participated m drug treatment prior to Baylor and her drug history began
during her adolescence. She is a multiple drug user with the most common drugs used being
cocaine and herom. Of the various demographic and social factors that accompany her mto
treatment at Baylor, four factors will have the most impact on whether she will succeed. She is at

0 Appropriateness of the KEY / CREST Program
Page 6 of 70
higher risk of fkilure if she has any of these four fixtors:
(1) A psychiatric history (formal diagnosis andor emotionaVpsychological diBiculties),
(2) If she has contemplated suicide,
(3) If she has attempted suicide, or
(4) If she has difJiculty in controlling her temper or her behavior is hostile /violent.
The first five weeks are the critical weeks for new participant at Baylor. If she Ms, it is likely she ,
I
will do it during the orientation of the treatment. If she, however, remains m the program through
the 49* week (the mid pomt of the treatment cycle), she is most likely gomg to remain m the
program and be successllly discharged fiom KEY.
Dr. Bonuiwell Haslett was contracted by the Delaware C r h i d Justice Council to
conduct an analysis of the c u r r i a used at Baylor and CREST and to assess the environment
of both program to determine gender appropriateness of the program. Dr. Haslett concluded
that the program was gender appropriate but made two mainrecommendations. First that the
CREST program be made smgle sex and second that Baylor and CREST reassess the hierarchy
structure of the program to be more therapeutic m nature. Other observations mchded the need
to reduce the level of hostility m encounter groups, mcrease direct access of clients to counselors
and updating the curriculum.
Overall, program clients (‘‘fBmily members”) considered the program gender appropriate
and the women did not feel unsafe or threatened by the presence of males m the program, Clients
did voice various concerns including the need to reduce the level of hostility m encounter groups,
more focus on the nature of addiction and the various types of addiction rather than behavior
modification and more direct access to counselors. Family members were supportive of the
program design m which fhmily members are m positions of authority to enforce family rules.
Overall, they found the rules fair, although some complaints were made m regard to favoritism m
enforcement of those d e s . Some of the women noted that the program needed more female only
encounter groups and that the program needed more programming designed to help addicts make
peace with their families outside and to maintain contact with their children. Although the
program clients were not without complaints, they agreed that the program can offer an addict a
@ Appropriateness of the KEY / CREST Program
Page 7 of 70
e way to “straighten up” and that m the end “the addict has to want to change” and ifthe addict
does not want to change it does not matter what program she is in.
Recommendations
1. A review should be conducted on how people are placed in CREST North

and South.
Currently a person can be placed m CREST North or South by court order, as a
condition for release fiom Baylor or Gander Hill or by request by an inmate
without being required to go through the KEY program. The program needs to
have a reduced number m order to end the “crowded” aspect of the program and
include inmates who “want” to make a change m their lives. Inmates who are
placed m CREST North or South under order and who don’t want to be there take
away fiom the therapeutic nature of the program.
2. Both Dr. Haslett and the program directors agreed that the more outside
training for the staff is needed. The curriculum should also be reviewed to
make sure that it is current and that it is relevant to drug treatment
programming and gender appropriate.
3. An assessment is needed to determine what actually needs to change to

improve the environment and therapeutic value of program operations and
what views from the “family” members are based on the negative behaviors
of addicts and people who are incarcerated. The meetmgs with farmly members
and program staffmade clear that there are various differences of opinion as to the
quality and nature of what is treatment and whether the program offers ‘YBmily“
members an environment for positive change. It is not proposed that the program
does not provide such an environment but that the ‘Ybdf’ members perceive it as
not being a positive environment. Although the program was found to be gender
appropriate, there appears to be differences m what the program directors and
counselors define as treatment as compared to what the ‘‘fhdf’ members define
as treatment. This is signijkant because research has shown thatpeople in
treatment are more success.1 when they viewprogram modality as treatment

@ Appropriatenessof the KEY / CREST Program
Page 8 of 70
Literature Review
0
Statistics show that more than 74 million Americans have tried illicit drugs at least once in
their lifetimes.’ Drug use leads to many antisocial behaviors including dyshctional firdies and
criminality. As a result of drug addition and Criminal activity that OCCUTS due to drug use, prisons
in the United States have suffered large increases in population? One of the treatment programs
that have gained in prominence in treating drug addicts while in prison is the Therapeutic
Community (TC) m0de1.~DeLong explains that therapeutic communities “are guided by a
perspective consisting of four interrelated views of the substance disorder, the person, recovery
and right living.’4
View of the Disorder:
Physical dependency must be seen in the context of
the individual psychological status and lifestyle. The problem
is the person, not the drug.
View of the Person:
Individuals are distinguished along dimensions of
psychological dyshction and social deficits rather than drug
use patterns.
View of Recovery:
The goals of treatment are global changes in lifestyle
and identity.
View of Right Living:
Certain precepts, beliefs, and values are essential to
self-help recovery, social learning, personal growth, and
healthy living.5
According to DeLong the essential elements and concepts of the TC modality is that substance
abuse
is a disorder of the whole person. Recovery is a self-help
process of incremental learning toward a stable change in
behavior, attitudes and values of right living that are associated
with maintaining abstinence.6
“What distinguishes the TC fiom other treatment approaches . . . is the purposive use of the peer
community tofacilitate social and psychological change in individuals.”?Because of the view

@ Appropriatenessof the KEY I CREST Program
Page9of 70
a that it is b o u g h community mteraction, the behavior of the addict is changed, the “quintessential
element of the TC approach may be termed community as methud.’*
Therapeutic Communities m prison settings function under the concept that the addict
must be removed fiom the general population and placed m a separate area m which the negative
influences of prison are removed m order to create an environment that allows for positive
behavior change.’ TC’s view drug addiction as a symptom of disorder m the addicts’ life and not I
the cause of the disorder m the addict’s life.” As explained by Hooper, Lockwood and Inckdi: I
The treatment perspective of the TC is that drug abuse is a
disorder of the whole person - that the problem is the person
and not the drug, that addiction is a symptom and not the
essence of the disorder. In the TC’s view of recovery, the
primary goal is to change the negative patterns of behavior,
thinking, and feeling that predispose drug use.”
TC’s are based on the premise that feelings and thoughts r e d m behaviors and that “people
choose how they will behave [and] have fiee choice and are responsible for their own actions.”12
As explained by Inckdi, TC concept of drug addiction views
drug abuse as overdetermined behavior. That is, physical
dependence is secondary to the wide range of influences
that instigate and regulate drug-taking and drug seeking
behaviors. In the vast majority of drug offenders, there are
cognitive problems; psychological dyshction is common;
thinking may be unrealistic or disorganized; values are
misshapen, and frequently, there are deficits in education and
employment skills. [Dlrug use is a response to a series of social
and psychological disturbance^.'^
TC’s “seek to improve interpersonal skills and coping strategies so that clients may better handle
the problematic situations they encounter in their everyday lives.”14 TC’s view the client as a
person in need of habilitation rather than rehabilitation. “Whereas rehabilitation emphasizes the
return to a way of life previously known and perhaps forgotten or rejected, habilitation involves
the clients initial socialization into a productive and responsible way of life.”16

Appropriateness of the KEY / CREST Program April 2002 Final Report
Implemented at the Baylor Women’s Correctional Institute Page 10 of 70
The TC model m correctional institutions has three stages of treatment:
(1) An intuke or primary stuge m which the client is mtroduced to the rules of the TC and
I
the main goal is to make adjustments m the behavior of the client;
(2) A transition or secondary stuge m which the client has been released fiom prison, is
participatmg m a work release program and is beginning to h c t i o n m the community;
and
(3) An tertiary or third stuge m which the client has graduated fiom the TC and is living i
m the community under probation ~upenision.’~
TC’s have been developed to h c t i o n usmg a holistic approach to the treatment needs of
the client.18 The holistic approach includes behavioral, cognitive and emotional the rap^.'^
Behavioral theory, which occurs during the primary stage, is geared to foster a positive demeanor
and pro social conduct m the client upon entry mto the TC.20 The ‘‘focus is on his behavior as
opposed to thoughts and feelings.”” Focus is on behavior because behavior is the most evident
aspect of the program. By ‘Yiocusmg first on behaviors, clients are more likely to become engaged
m treatment because they can readily understand and assimilate the treatment plan to change
behaviors.’a’ Cognitive therupy is designed to help the client recognize flaws m thhl~ing.2~
The
focus is to help the client understand how his thinking patterns have developed over time and how
to form new thinking patterns that are positive. The cognitive therapy occurs during group and
individual sessions.24 EmotionuZ therupy helps the client deal with unresolved conflicts that have
resulted m feelings and behaviors that have m turn lead to drug use and other antisocial
behavi01-s.’~ The goal is to provide the client with a ‘’better understanding of how they think and
feel about themselves and others.y’26
TC’s have been divided mto two general models: democratic TC’s and hierarchical or
concept based TC’S.’~ TC’s m the United States tend to use the hierarchical model while the
TC’s m Europe and m the Nordic countries tend to use the democratic model.% In the
hierarchical TC design, the clients themselves govern the program under the supervision of staE?’
Each client moves up the hierarchy based on improvement m attitude and participation m the
program Clients, who have been m the program for longer periods of time, are given supervisory
0 Appropriatenessof the KEY /CREST Program
Page 11 of 70
authority over clients who have been m the program for shorter periods of time. Clients who have
been m the program for longer periods of time are expected to be positive role models for
younger clients and are expected to assist m the therapy of younger clients as they move through
the TC process. Promotions and other privileges are used as positive reinforcement of positive
behavior and TC rules and regulations are all geared to provide a therapeutic guide for positive
behavior of the clients.3o The environment of positive codontation m group sessions addresses
-
inappropriate behavior of clients3*thus creating a ‘24 hour - per - day learning experience m
which a drug user’s transformation m conduct, attitudes, values, and emotions are mtroduced,
monitored, and mutually reinforced as part of the daily regime.”32
The State of Delaware instituted a TC m the Multi-Purpose Criminal Justice Facillty
(kuown as “Gander Hill”) on July 21,1988 based on the principles and concepts of TC’S?~
Gander Hill is an all male correctional facility located m Wilmington, Delaware. The KEY
program was designed for application to male drug addicts. In January 1994 a TC was opened at
the Baylor Women’s Correctional Institution to provide drug treatment based on TC model h r
women. Smce the implementation of TC at Baylor, research has shown that the TC model is
0 effective for women but only with modiiications, chief of which is the reduction of the use of
codontation between clients.34
Although research on TC’s that specialize m women is limited35m regard to published
studies, research shows that certain factors lead to mcreased success. These include:
(1) Higher lengths of stay m the program (12 to 18 months)
(2) Small program size (5 to 20 women), female sensitive programming including child
care, parenting skills, and personal mental and physical health
(3) Programming that mchdes addressing past sexual and physical abuse
(4) Training m improving interpersonal skills with both men and other women including -
the ability to learn how to trust.36
Research has noted that various factors idluence the length of stay m a TC program, some of
which origiuate m the program and some originate m the ~lient.3~
The factors that influence

Page 12 of 70
length of stay inherent to the TC program itselfmclude:
0 (1) Low turnover of program staff
(2) Decreased use of confiontation
(3) A nurturing and affirmative environment
(4) Participation by the clients
( 5 ) The presence of positive role models
(6) Activities that foster bonding among ‘‘fimilf’ member^.^' i
The &tors that influence length of stay inherent to the client include:
(1) Increased age (25 and older),
(2) Higher education (high school or above),
(3) Less children (2 or less),
(4) Less likely to harbor suicide thoughts3’
( 5 ) Flexiile views and constructions of what is and is not treatment?’
The issue of gender appropriateness is hqortant for two reasons: First, TC’s, like other
substance abuse treatment programs, were originally designed for men and were not designed to
0 deal with the issues that are specific to women. 41 Secondly, “women appear to benefit fiom
Merent treatment modalities than men (e.g. less confiontational), and their sexual history” makes
trusting difiicult?’ Additionally, women bring various sexual relationships, M y relationships,
children, criminalhistories, drug and alcohol abuse histories, and other personal issues m
conjunction with drug addictions that are not usually found with male drug addicts. In reviewing
the literature Bouflfasd and Taxman note that
. . .male addicts . . .were more likely to have initiated drug
use in response to peer influences and as a means of obtaining
pleasure. On the other hand. . .female drug users were more
likely to have initiated drug use as a result of the influence of
their male sexual partners and also as a means of self-medi~ation.4~
The Delaware Health and Social Services, Division of Alcoholism, Drug Abuse and Mental
Health came to similar conclusions m a report on women-focused drug treatment noting

Appropriatenessof the KEY / CREST Program April 2002 Final Report
a Research on drug-dependent women has shown that women’s
treatment needs are Herent fiom those of men. Women
entering treatment tend to have low selfesteedselfworth, I
child care responsibilities, relationship issues and role conflict,
lack of trust,particularly of other women, identity issues, histories
of sexual andor physical abuse, extensive medical needs and
mental health issues, particularly depression. Effective treatment
for drug-dependent women must address these and other issues
specific to women4
i
Tn response to these factors, a TC for women must provide an environment that can deal with
these gender specific issues m order for the clients to be successll m dealing with the various
issues and attitudes that support their antisocialbehavior that resulted m drug addiction and
mcarceration.
Research has also shown that there are several programmatic operations that have been
found to be essential for a TC to be gender appropriate for These programmatic
operations mclude:
(1) Staff expertise m women’s health care and health needs
a (2) Staffknowledge and expertise m working with the various emotional, physical and
psychological abuse incarcerated women tend to d e r fiom
(3) Staff ability to ‘keach” the women and understand the “streets” from which they come
(4) Providing a “safe” environment m which the use of rewards and punishment is done
WlY
( 5 ) A sense of ‘‘fhmilf’ m order to help clients develop abilities of trust and bonding to
others
(6) Addressing histories of abuse and the results of negative relationships with men with -
a focus on teaching how to build and maintain positive relationships
(7) Program coordination with social webre agencies to meet the needs of clients who
are mothers and have children to care
The issue of gender appropriateness is more than simply making sure that the TC is less
masculine m implementation. Both the design of the facility and the atmosphere of the facility and
Implemented at the Baylor Women’s CorrectionalInstitute Page 14 of 70
e the operation of the drug treatment program must contribute to the creating of a safe environment
for women dealing with the social stigma of bemg an addict and their embarrassment and s h e m
being drug-de~endent.4~
Research has demonstrated that women who have drug addictions are
differentemotionally, socrally and psychologically than male addicts. 48 DeLeon and Jainchill
point out that
female addicts are generally younger than males when they
enter treatment. They are less involved in serious crime,
more often come fiom deviant families m terms of drug /
alcohol use, cmmbhty, and psychopathology; and more
women have attempted suicide.4’
B h e points out that there are basic

differences between male and female physiology [that]
influence the results of alcohol and other drug ingestion.
One such diffaence is the relative content of body water
and body fit. Women have less body water per pound
than men. Since ingested ethanol is distriiuted in total
body water, women will attain a higher blood alcohol
level fiom an equivalent dose of ethanol per unit of
body water?’
Wilsnack, et, al, points out that because women “reach higher blood alcohol concentrations than
men fiom the same weight-adwed levels of consumption [women] may develop liver disorders
after lower levels of regular alcohol consumption and earlier m their drinking careers than men.”51
Farrell explains that women who are drug users are ‘less likely to become involved in systematic
or compulsive violence as a result of drug use [and they] have been kund to have high levels of
community, family and social dyshctions fiom which drugs offer an escape.”52 Reed points out
that
Women have historicallybeen more likely than men
to use socially acceptable drugs and to perceive their
use of psychoactive substances as a form of coping.
Men are more likely to engage m rule-breaking behavior
and illicit drug use, and to perceive their use as serving
social and recreational purposes. Although alcohol [use
and] drunkenness is more permissible for men [there is]
strong societal disapproval of such behaviors m women
has led to more shame and secrecy for women, and less
recognition of women’s ~ ~ C O ~ O I ~ S I I I . ~ ~ I
Women generally have issues of maternity and childcare pressures that can both motivate and
prevent them fiom seeking and remaining m long term treatment m a TC.54 Research has also
found that some women who are incarcerated have mental health disorders55and they “seem more
psychologically disturbed than men [and] are characteristically worse, particularly on measures of
depression, anxiety’ and elfe esteem."^^ As Reed points out
While men often become profoundly depressed as their
denial begins to ebb, the depression and low self-esteem
m many drug dependent women are very severe even before
they enter treatment and may be a major impediment m their
ability to seek he@ f
ix themsel~es.5~
The reasons for the depression m women come both fiom the self deprecation of bemg an addict
as well as societal reactions to women who have addictions that are more harsh than those to
Research on the differences m results of men and women who participate m TC program
include the following:
(1) Women drop out of programs m the earliest stages of the program more fiequently than
men
(2) Retention rates over a one year period are about the same for men and women
(3) The level of behavior improvement (no criminal activity or drug use) for both men and
women are both related to longer lengths of stay m the program
(4) Psychological improvement is also related to length of stay but gains are sigdicantly
better for
In regard to the “sigdicantly better” psychological improvement m women over men, DeLeon
and Jainchill suggest that the difference is based on the concept of the TC:
Treatment focuses upon changes m conditioned social roles
as an integral element m its approach to recovery. Although
both sexes improve psychologicallyythe positive change for
women is larger because much of the self-stigma of their
Appropriatenessof the KEY I CREST Program April 2002 Final Report
disorder is removed. For men, drug abuse does not convey
the same negative social stereotype. Socially conditioned
self-stigma is less relevant and hence its elimination does not I
improve the men’s psychological status to the extent that it
does with women!’
The “different patterns of behavior and psychosocial copmg m women [is not without therapeutic
vahre because] depression, anxiety and low self-esteem - common patterns m women - can be
very usefill motivators within treatment ifa therapist knows how to work with them.’h’ i
Thus, for a TC to be gender appropriate it must not only o& the basic model for TC
treatment it must be sensitive to the special needs and issues that women have. The program
must integrate mto its operation an understanding of the difference between men and women
generally, but also the differencesbetween male and female drug addicts. The TC must have an
environment that is perceived by the women to be just, fiendly and safe. They need to feel safk
and able to secure help without undue confiontation that is similar to the emotional abuse they
may have previously suffered. As observed by the Delaware Health and Social Services report
Women-specific treatment ensures that the means used to
confiont clients does not undermine the treatment process,
does not mirror abusive authority figures that many of the
women have encountered and is not administered without
.
appropriate support. .. A dual approach where rules are
enforced m combination with support and encouragement
is most compathle with a women-specific treatment approach.
Effective treatment for women focuses on positive reinforcement
rather than punitive responses.62
The presence of child care education, positive social skills training, mental and physical hygiene
courses, positive emotional bonding, assertiveness training, and teaching women how to find
positive fiends and relationships are all part of making a TC program gender appropriate.
Specifically, the goal of a TC program for women is to change both behavior and self-perception
of the clients. For an mterestmg article on how a drug treatment program was restructured to
accommodate women, see Gloria Zank~wski.~~
a Process Evaluation Assessing the Gender

Appropriateness of the KEY / CREST Program
Grant Number 99 - RT - VX - KO16
Page 17 of 70
e Program Description
Therapeutic Community research has observed that after care is needed to continue and
maintain the positive change in a TC graduate.64 One of the methods used to meet this need is to
establish a work release program based on the TC model. In 1990, the Center for Drug and
Alcohol Studies at the University of Delaware received a five million dollar grant fiom the
National Institute on Drug Abuse O A ) to implement the nation’s first work release therapeutic
The implementation of the TC model to a work release program did not happen
without some interesting and challenging dficulties, including the clinical director being arrested
for possession of drug paraphernalia (after being removed fiom the program due to allegations of
sexual harassment of female clients), local “ w m be”politicians attempting to “shake down” the
program for money, community “not in my back yard” reactions, institutional road blocks from
the University of Delaware, program administration changes, and philosophical differences with
Department of Correction staff and misunderstandings between researchers and treatment
In spite of these challenges, the CREST program began operations, resolved critical issues and
0 has continued since 1990.
The CREST program operates on a similar design as the KEY TC program. The clients
enter the program and progress through the program in phases.67 “The treatment philosophy at
CREST Outreach Center is similar to that of most [therapeutic communities] in that it is based on
the notion that substance abuse and addiction are symptoms of a wider behavioral disorder and
that, in order to discontinue drug use, all aspects of an addict’s We must be reevaluated and
changed where appropriate.”68CREST contains the typical hierarchical system with a clearly
defined chain of command with established rules, consequences and rewards6’ CREST is a co-
ed program in which clients arrive by court order and/or through graduation of the prison based
KEY program at Baylor or Gander
2 A client can be placed into the CREST program by either by judicial order or by classification by the Department of
Corrections. The Court can place a person in CREST by ordering the person to be held on a level III (placed on
probation), held at Level V (incarceration)then placed in CREST, directly sentenced to CREST fiom the community, or

Page 18 of 70
While the TC program at Baylor operates on a three-phase schedule, in which women
0 have between six and eighteen months remaining on their sentence,7othe CREST program is a
I
fie-phase model that operates for six The five phases include the following:
(1) Inphase one, the new client is given orientation to the program including written
materials about CREST, program rules and regulations and an explanation of the rank
structure. Phase one lasts about two weeks.
(2) Phase fwo emphasizes participation m the meetings, jobs within the fiicility and general
involvement m the daily operations of the community. In this phase the client is expected
to learn through experience how to function within a community and meet one’s
obligations and receive constructive criticism when obligations are not met. Phase two
lasts about eight weeks.
(3) In Phase three the client is expected to continue to participate m the community by
acting as positive role models for newer clients and begin to accept authority over clients
with less time. Phase three last for about five weeks.
(4) In Phasefour the clients’ begin transition out of the program through the process of
finding employment outside of the fiicdity. Job interview training and how to make
positive impressions on employers is part of the main focus. Phase four is about two
Weeks.
(5) Phasef i e mvolves clients obtaining and maintaining gainfid employment outside of
CREST. Clients still live in CREST but begin to search for housing. Phase five lasts for
about seven weeks. “At the end of approximately seven weeks, which represents a total
of twenty-four to twenty-six weeks at CREST, residents have completed their work
release commitment and are free to live and work m the community as program
graii~~ates.~~~~
Since the opening of CREST, various process and outcome evaluations have been
conducted on the implementation, operation and results of the Neilsen, Scarpitti, and
placed in CREST as a condition for sentence. The Department of Corrections can place any inmate into CREST

Procms Evaluation Assessing the Gender Grant Number 99 - RT - VX - KO16
Appropriatenessof the KEY /CREST Program April 2002 Final Report
I n ~ i a r dcompared
i~~ inmates who were released from prison and slotted to enter work release. The
two groups compared were comprised of inmates randomly selected to entyr CREST (CREST
group) and those who participated in Delaware’s conventional work release program (comparison
group). Interviews were conducted on a total of 689 respondents (248 - CREST group and 441 -
Comparison group) to create a baseline data. Of the 248 CREST group participants 191 were
interviewed 6 months after prison release and 145 CREST participants were interviewed 18
months after prison release. Of the 441 Comparison group participants, 320 participants were
interviewed 6 months after prison release and 162 participants were interviewed 18 months after
release fiom prison. The study assessed drug use during the 6 and 18-month periods (relapse) and
whether participants had been arrested and charged with a crime (recidivism). Based on self-
report interviews, “the relapse and recidivism rates for CREST clients are signiscantly lower than
those of the Comparison group. At the 6-month follow-up, only 16.2% of the CREST group had
relapsed, relative to 62.2% of the Comparison group. Similarly, only 14.7% of CREST clients had
been arrested by the first follow-up, as opposed to 35.4% of the Comparison gr~up.’”~
At the 18-
month point, 5 1.7% of the CREST clients had relapsed compared to 79% of the Comparison
group and the recidivism rate for the CREST group was 38.2% compared to the 63% rate of the
Comparison Although the recidivism and relapse rates for the CREST group mcreased
between the 6 and 18 month periods, the CREST group had “significantly lower rates than the
Comparison group, a h d h g that speaks to the effectiveness of the combined TC and work
release approach relative to conventional work release for a comparable group of
When the relapse and recidivism data for the CREST program was assessed no sigdicant
difEerences were found between the genders?8
Lockwood, Inciardi, Butzin and Hooper, conducted a companion study comparing clients
who received treatment through the KEY program only and did not enter CREST (KEY group),
clients who entered CREST directly fiom general population prison (CREST group), and clients
who received treatment m KEY and then entered CREST (KEY- CREST Participants
program at its discretion or a person can transfer fiom one CREST to another.

were interviewed upon leaving prison, six months after completing work release and 18 months
after leaving prison. At the six month mterview" 54.5% of those m the KEY group were drug
free as opposed to 94.1% of the KEY / CREST group and 84.5% of the CREST group. While the
75% of the KEY group were arrest free six months after leaving prison, 86.5% of the CREST
group was arrest free and 97.1% of the KEY/CREST group was arrest free. The low recidivism
and relapse rate for the KEY/CREST group can be expected since the first interview occurred
about the same time as completion of CREST. Any violation of CREST rules, which would
include being arrested or using drugs, results m a return to prison."
Lockwood, Inciardi and Surratt, compared a KEY/CREST group, a CREST group and
group of released inmates who did not participate in KEY or CREST (Comparison group).82 The
same procedure of mterviews at the 6 and 18 months after release from prison was used as
previously noted research. The results were similar to previous studies. At the six-month point
96% of the KEYICREST and 83% of the CREST group were arrest free while only 71% of the
Comparison group was arrest free.83 When respondents were asked ifthey had committed any
crimes since their base line interview, 85% of the CREST and 97% of the KEY/CREST groups
a were crime fiee opposed to the 51% of the Comparison group that was crime free.% Drug use
produced similar results, in that 20% of CREST and 6% of KEY/CREST group reported relapse
opposed to 45% of the Comparison group. "The respondents in the CREST group who relapsed
reported use of alcohol or &juana [while] the Comparison group [reported relapse use] of
alcohol, marijuana, crack and cocaine."85
All three studies concluded that participation m CREST after KEY produces the highest
rate of drug and crime free behavior measured at 6 and 18 month intervals. All three studies are
preliminary m that the majority of measurements were at the 6 month period, meaning that the
KEY and KEYKREST groups have not had an extended period of time out of the confinjng
environment of treatment (CREST). As the Neilsen, Scarpitti, and Inciardi study found, there
was an increase in relapse and recidivism of the CREST group between the 6 month and 18
month follow up mterviews; 16.2% relapse rate at 6 months and 51.7% at the 18 months.86
Simkly,the CREST group had a 14.7% recidivism rate at 6 months and 38.2% at 18 m~nths.~'
Implemented at the Baylor Women's Correctional Institute
Page 21 of 70
a On the other hand, ‘’both KEY-CRESTand CREST clients reported better maintenance of drug-
iiee and crime-fi-eebehaviors than did the comparison group clients. From this preliminary
analysis,it appears that CREST,a work-release TC,is effective m reducing both criminal activity
and drug use.’58
Farrell conducted a study usmg the data li-om the studies previously noted, specifically
looking at the women who participated m CREST to determine the effectiveness of the CREST
therapeutic community m meeting the specific needs of women to form and maintain social bonds
m the community after release.89 Farrell took data li-om interviews at the 18-month period and
compared women who were m CREST to those that were not (CRESTvs. Comparison). At the
18-month interview, the comparison group had a relapse rate of 50% compared to a 39% rate for
CREST.90Farrell noted that the CREST program had better relapse rates for alcohol and
marijuanause than the Comparison group, 26.8% - 65.8% and 26.8% 34.2% respectively.’’ -
These results are m line with the results reported by Lockwood, Inciardi and S ~ r r a t t .Farrell
~~
reported that “women participating m the CREST program are equally likely as the women
participating m the [comparison group] to be arrested or selfreport mvolvement m a crime at the
a eighteen month mtervie~.”’~Farrell reported that when comparing CREST to the comparison
group m regard to the ability of women to secure social support and community connection at the
18-month pomt, m certain support systems “the women participating m the CREST program were
significantly more successfid.’’94 The CREST group was shown to have higher rates for continued
treatment, treatment attendance and connection with fiiends andor relative^.^' After examination
of isolation and identification indexes, Farrell concluded that there was no signiscant difference
between the CREST and comparison groups in regard to connection with the
Farrell reported that mvolvement with CREST did not sign5cantly predict recidivism or drug use
relapse and concluded “that participation m the treatment program alone was imufljcient m
explaining why clients relapsed or returned to crime.”97 These conclusions are contrary to the
results of the three studies previously noted.

a Scope and Methodology
In January 1994 a forty-two-bed TC program was instituted at Baylor through a grant

fi-omthe Center for Substance Abuse Treatment (CSAT)?' The University of Delaware Center
for Drug & Alcohol Studies was awarded a grant fi-omthe Center for Substance Abuse Treatment
to conduct a three-year process evaluation of the progrmg9 The researchers at the Delaware /
I
Center for Drug & Alcohol Studies have published numerous articles and presentations based on
their evaluation of the TC programs at Baylor and Gander Hill.'oo In July 1999 the Delaware
Criminal Justice Council received a grant fi-omthe National Institute of Justice to conduct a
process evaluation on the TC program in Baylor and the CREST work release programs to assess
whether the treatment continuum is gender appropriate and to make recommendations to the
programs regarding necessary improvements.
A four-step process was designed to assess the gender appropriateness of the therapeutic
community treatment program at Baylor and the CREST work release program. The process is
outlined as follows:
a
Part One: Assess recent graduates of Baylor as a basis to create a profile of program
participants and secure background data for survey / interview questions.
Gather information on those who were discharged fiom the program during calendar year 1999.
Gather demographic, drug history, prior criminal history, etc.
Goal: To determine drop out points along the continuum of the treatment model. To review the
case files to discover any patterns in the client participation and review demographic data in the
KEY / CREST programs. This data served as a guide for the design of interview questions for
women currently participating in Baylor.
Part Two: Curriculum review.

Review policies, procedures, program design, and program process to assess gender sensitivity.
Goal: To assess ifthe program as designed and implemented is gender specsc and gender
Page 23 of 70
a appropriate. Focus was on the written policies, physical layout of the kility’ staff training, staff
attitudes, and mtangiile &tors that inthence the perception of a program to a w o r n as
threatening or non threatening (safe or unsafe). The curriculum review was conducted by Dr.
Beth BonniweU Haslett, Professor of CommUncation, University of Delaware.
Part Three: Assess client satisfaction.

Interview current participants m the TC program at Baylor.
Goal: To assess what current participants think about the program and treatment model. A
database was constructed to search for any consistencies or variables that would address the issue
of gender appropriateness or lack of such m the operation of the program fiom the participants’
pomt of view. Data fiom the interviews was M h e r analyzed to help prepare additional questions
for focus group interviews with Baylor and CREST participants.
Part Four: Focus group analysis.

Conduct focus groups to discuss the operation and implementation of the Baylor and CREST
0 programs with program participants and staffto assess gender appropriateness. Ten focus groups
were implemented. The focus groups were implemented m two rounds.
Round One: Nine focus groups were conducted. Three focus groups were conducted for each
pomt m the treatment model: Baylor (TC only), CREST North (TC and work release) and
CREST South (work release only) had three focus groups each. Because TC’s are organized by a
strict hierarchical system, the participants m each focus group were about equal m rank to reduce
the possibility of participants bemg intimidated by making honest comments about the program
and its operation m the presence of superiors.
Goal: To provide an opportunity for open discussion on the gender appropriateness of the
program and to discuss the theories behind the model as well as gain insight mto concerns of
program participants.

Page 24 of 70
a Round Two: Post preliminary report focus groups. This focus group was composed of
program directors and representatives of the counseling s M . This focus group reviewed the
research report developed fiom idormation and data fiom parts one, two, three and the nine
focus groups.3
Goal: To provide an opportunity to discuss the results and observations of the research team and
receive comments fiom program administrators and participants.
F’inal product: A TC program e v h t i o n encompassmg the information and data secured m parts
one through four and will provide the following:
(1) A review of the current status of programs available for female state prisoners m
Delaware;
(2) Assessment of the level of gender appropriateness of the TC program components

and any recommendations for improvement;
(3) Assess how the co-educational work release environment fits mto gender
appropriate drug treatment continuwq and
0 ’ (4) Provide constructive recommendations to the Baylor and CREST program staff.
The above descriid evaluation model was approved by the National Institute of Justice
and the Delaware Crjminal Justice Council Institutional Review Board m compliance with federal
regulations to protect program evaluation subjects.
The original design included an eleventh focus group with program clients reviewing the preliminaryreport. This
focus group did not occur due to concerns raised by two ofthe three program directors. The program directors believed
that the preliminaryreport was negative in regard to its conclusions about the operation of their programs and that such
views would validate negative behaviors of the clients - that the program does not work thus they did not have to
cooperate with it. The concern was that since addicts are looking for a way to say the program does not offer anything, a
report that could be viewed as verifjmg that view would become detrimentalto treatment. The researchers decided, as a
matter of reality and in deference to the views of treatment professionals, that seeking the eleventh focus group would
not be advantageous.

Appropriatenessof the KEY /CREST Program April 2002 Final Report
Detailed Findings
0
Part One: Assess recent graduates of Baylor as a basis to create a profile of program
participants and secure background for survey / interview questions.
Data was secured fiom case files of women who had been discharged fiom the
Therapeutic Community (KEY Village) program in Baylor Women’s Correctional Institute in
1999 to prepare the survey instrument used for the interviews given to the women in Baylor
during the Fall of 2000.’0’ Demographic data, criminal history information, medical, prior drug
treatment histories, and program success or failure was secured fiom 105 case files. The data also
provided a profile of the women who participated in the Baylor program. This profile was
considered to be reflective of the current population of women in the KEY village program for
purposes of designing survey questions. Discussed in this section will be the results of analysis of
these 105 cases.
Of the women in the 105 case files, the majority of them were Caucasian (52.3%). The
remaining racial distribution was AfEcan American (42.9%), Hispanic (3.8%) and Asia / Pacific
0 Islander (1%). The majority of the women were single (60.6%) or divorced (20.2%). “The
combined percentages of unmarried women (88.5%) are substantial enough to consider an
interview question based upon the support network of significant others as being integral in
successfhlly completing the KEY Village treatment program.”1o2The women tended to be Zess
educated with 57.1% of the women having less than a 12* grade ed~cation.”~
Only a small
minority (2.9%)had a college degree and only meen (15.3%) percent of the women had an
education level of 12* grade or higher. The majority of women (63.5%)had apoor working
history in that they were not able to hold a job for longer than one year. Less than thirty (29.8%)
percent had work histories in which a job was held for three years or less. Almost the majority
(49.5%) of women were middZe age adults between the age of 3 1 and 50 years old. The single
highest age grouping (25.7%) of the women was 26 to 30 years old. The majority of women
(59%) had children, and the majority of women with children (62.3%)had three or fewer
children. While the number of children or the presence of children did not prove sigdicant to
Process Evaluation Assessing the Gender Grant Number 99 - RT - V X - KO16
April 2002 m a l Report
Page 26 of 70
discharge status, those women with children were more successll than those without children.'"
0 Research on women m the criminaljustice system has noted that a majority of them have histories
of abuse.'" Review of the data fiom the 105 case files reveal that of those files with abuse
information (74.3%), the majority of the mmen (92.3%) had histories of emotional, physical and
or sexual abuse.'& A majority of case files (74.3%) provided information on the type of abuse
occurred. More than thirty (35.9%) percent of the women had histories of combmed emotional,
physical and sexual abuse.'" The majority of women (56.4%) SufGered abuse that included sexual i
abuse.
Research also noted that women m the criminaljustice system have histories of psychiatric
disorders.'o8 Review of the data fiom the 105 case files reveal that of those files with psychiatric
history information (98.1%), the majority of women (63.2%) had no prior psychiatric histories
(formal psychiatric dmgnosis). Of the 105 cases m which data are available, a majority of women
(72.2%) had experienced depression (Ntotal cases = 79), a majority of women (70.1%) had
experienced anxiety/tension/nervousness (N total cases = 77), a majority of women (63.6%) had
experienced trouble comprehending, concentratmg or remembering (N total cases = 77),'09 and a
0 majority of women (61%) did not receive treatment for psychological problems (Ntotal cases =
77).
Yes 10 20 30
No 36 26 62

I) Appropriateness of the KEY I CREST Program
April 2002 m a l Report
Page 27 of 70
* Research has shown that women m the criminaljustice system that have histories of suicide andor
attempted suicide and that attempted or contemplated suicide can affect the success m treatment
pr~grams.''~ Although a minority of women had contemplated suicide (32.4%) or attempted
suicide (3l%),both weyefound to be significantly related to discharge (successful or
unsuccessful) as was the general variable of having apsychiatric history. Contemplated suicide
had a chi square sigdkince of .060, attempted suicide had a chi square signiscance of .036, and
the presence of a psychiatric history had a chi square significance of .026 to successful or
unsuccessful discharge.
I Yes I 10 I 12 I 22 I
Yes 11 12 23
I No I 34 I 14 I 48 I
Review of the data fiom the 105 case files reveal that of those files with prior drug
treatment information (97.1%), the majority of women (77.5%) had been involved in prior drug
e Process Evaluation Assessing the Gender

Appropriatenessof the KEY / CREST Program
Page 28 of 70
e treatment before Baylor."' Prior treatment was a broad variable and covered programs ranging
fkom detoxification to long-term inpatient and/or outpatient treatment programs."2 The majority
of women (55%) had one to five prior drug and / or alcohol treatments upon entering Bay10r.''~
Of the 105 cases m which the outcome ofprior drug / alcohol treatment is available (76.2%), the
majority of women (56.3%) were successful m completing a prior drug treatment pr~gram."~
Of the 105 cmes in which age at onset of drug use m known (98.1%), the majority of
mmen (63.8%) began to use drugs between 13 and 20 years old. As shown below, drug use i
peaks during the teen years and then declines in the young and older adult years.
I 12 and under
I I5 I 14.6
I
1 13 to 15 years old
I 41
1 39.8
I
16 to 20 years old 26 25.2
21 to 29 years old 14 13.6
I 30 to 39 years old
I 6
I 5.8
I
1 40 years old and older
I 1
I 1 .o
I
Of the 105 cases in which type of drug use and favored drug used is available (98.1%), the
majority of women (79.6%)preferred using a combination of d r ~ g s . "The
~ most common drug
combination was cocaine and/or heroin with methadone or a hallucinogen. Cocaine and/or heroin
were also combined with cannabis.'I6
Of the 105 cases, forty-five (45.2%) of the women were discharged successfblly fiom the
KEY treatment pr~gram."~
Only four variables werefound to be significantly related to
discharge:presence of psychiatric history (Chi Square = 0.26), attempted suicide (Chi Square =
Appropriateness of the KEY /CREST Program April 2002 h a 1 Report
Implemented at the Baylor Women's Correctional Institute Page 29 of 70
e .036), contemplated suicide (Chi Square = .060) and trouble m controlling violent or hostile
behavior (chi Square = .019). As shown below, those who had the ability to control their
behavior were much more likely to be successllly discharged *om Baylor than those women
who could not.
Yes 14 15 29
No
I 31
When looking at discharge patterns, the period including thefirstjve weeks is the single
highest dischargepoint.'I8 Of the total unsuccessful discharges fiom Baylor (N = 47), half
(53.2%) are accounted for within the first five weeks (the orientation phase). The remaining
women, who were discharged fiom the program, were discharged between week 6 and 49.Il9
None of the women were unsuccessfully discharged were in the program past week 50.
In conclusion, the analysis of the women who were discharged fiom Baylor in 1999
provided a profile and template for survey and interview questions that were developed for the
women who are currently in Baylor and in CREST. The profile of the typical participant in the
TC program is a woman who is Caucasian or AfEcan American, with less than a high school
education, between the age of 3 1 and 50 years old. She has children and has suffered some level
of abuse in her past. Although she does not have a formal psychiatric treatment history or
diagnosis, she has suffered depression, anxiety andor an inability to concentrate. She may have
entertained thoughts of suicide or has attempted suicide. She participated in drug treatment prior
to Baylor and her drug history began during her adolescence. She is a multiple drug user with the
Process Evaluation Assessing the Gender -
Grant Number 99 RT - VX - KO16
e base drugs used bemg cocame and heroin. Of the various demographic and social factors that
accompany her mto treatment at Baylor, four factors will have the most impact on whether she
will succeed. She is at higher risk of hilure if she has a any of these four fhctors: a psychiatric
history (formal diagnosis andor emotiodpsychological dZiculties), if she has contemplated
suicide, if she has attempted suicide, or if she has difiiculty m controlling her temper or her
behavior is hostile / violent. The first five weeks are the critical weeks for a new participant at
Baylor. If she it is likely she will do it during the orientation phase of the treatment. If she
however remains m the program through the 4 9 week
~ (the mid pomt of the treatment cycle), she
is most likely gomg to remain m the program and be successfirlly discharged fiom KEY.
Part Two: Curriculum review.

As part of the process of determining the gender appropriateness of the TC at Baylor, Dr.
Bonniwell Haslett conducted an analysis of the c u n i m 1 2 0used at Baylor and CREST as well
as assessed the tangiile and mtangiile environment within the TC m regard to how the facilities,
s t a policies and procedures impact the operation of the program. The goal was to assess the
presence or absence of factors that limit the gender appropriateness of the TC model m Baylor
and CREST. There are various factors that can influence the gender appropriateness of a TC
program m a women's facility. These include differing philosophies between TC's and
correctional facilities and the quality of communication between staff members and between staff
members and program clients. The report by Dr.Haslett was used to provide guidance for both
interview focus group question formation and context for survey results. KEY observations are
reflected and summarized in this report; for a 111 review of Dr. Haslett's assessments of the
program, a copy of her report is included m appendix tab 2.
One of the factors of implementation of a TC m a correctional fkcility is dealing with the
philosophical differences that are inherent between the TC model and corrections.'21 Smce the
implementation of the TC program m Baylor and the institutionalizationof the CREST program,
many of these dZiculties and outright biases between the two s t a B have been ironed out.'22
Haslett reported that additional and continued communication "to discuss pressure points and
ProcessEvaluation Assessing the Gender Grant Number 99 - RT - V X - KO16
Page31 of 70
a dBculties, m non-Crisis circumstances would be helpful.”123Haslett noted that there are three
“pressure points affecting the overall program.”
First.The TC contmuum flows fiom the TC program m Balylor to the CREST program.
Because clients can enter the contmuum at dii%rent stages, “it is extraordinarilydifficult to
establish and maintam a consistent therapeutic Because clients can be directly
sentenced to the CREST program, TC encounter groups can have TC veterans (fiomBaylor or
Gander Hill) with newer clients who have a much lower understanding of the TC model and I:
possibly slow down the efficacyof the Thus “counselors are m a very di€Ficult position
of dealing with individuals who are widely divergent m terms of where they are along the path to
recovery.”126Haslett noted the following:
My observations suggest that this blended population makes
habilitation and recovery fbr clients even more difficult. Given
the variation m sentencing, and degrees of substance abuse and
criminality among clients, I do not h o w ifthis blend can be
altered or restructured. But ...it would be helpll to have
conversations among the TC directors and judges to discuss
sentencmg, who might bene& fiom TC programs and who might
not, and other related issues m order to strengthen the TC ~ r 0 g r a m . l ~ ~
Second. Client selection is another pressure pomt because the program staffbelieves that
“as many as 20 - 25% of clients have signiscant mental health issues, above and beyond
depression [and at] present the TC programs are not equipped to handle such clients.”’28 As
noted by the research on women who were discharged fiom Baylor m 1999, the staff is correct
with more than 30% of the women either having considered or attempted suicide and more than
90% having histories of abuse. Although the TC model is designed to deal with some of the
emotional andor psychological factors behind drug use, the prison based TC model is not
designed to handle clients with serious mdor chronic mental health difficulties. The issue of
having mentally ill clients m Baylor is reflective of the larger questions of ‘khether the DOC
should handle mentally ill mdividua.ls who have criminal records, or whether or not its more
Dr.Haslett recommended that the program
appropriate to treat such individuals else~here.”’~~
directors should have “the final authority as to whether or not clients are accepted mto the TC
Page 32 of 70
a programs [because they are] the best judges of who would benefit fkom the TC treatment.”’30In
the focus group with the program directors and counselors, the directors agreed with Dr.Haslett
I
and explained they have the authority to accept or reject anyone who does not meet the
requirements of TC drug treatment. They agreed that the current program at CREST has been
altered by the addition of sources mto the program (clients entering other than as KEY graduates
and the CREST program was designed for KEY graduates - thus the net of people in CREST has
grown) they are not without authority to control who comes mto the program,
Finally. The structure of the TC program at Baylor and CREST is the rational hierarcu
structure m which the rules are clearly defined and supervision of clients is conducted by clients as
well as professional sW.
Haslett made the following observation on the genaal concept and
operation of the TC program at Baylor and CREST:
The treatment components m the TC program include, behavioral,
cognitive and emotional aspects. Of these three elements, the
behavioral aspects appears to be the most heavily emphasized.
Although a behavioral emphasis is needed at the beginnjng of the
program, as mcoming clients ‘learn’ the system, it should become
less important over the duration of the program. The cognitive
and emotional aspects need to become more prominent because
it is these fwo components that will allow the client to remain
free of crime and substance abuse.13’
Research has noted that the structure of a TC,to be gender appropriate, must be such that
the women feel “safe” both emotionally and physically. As noted by DeLong, the purpose of TC
house rules should be to serve a therapeutic purpose rather than a managerial purpose:
In the TC all activities are designed to produce therapeutic
andor educational effects. These activities, singly and m
various combinations, constitute interventions that directly
and mdirectly affect the mdividual m the change process.
Indeed, it is this element of usmg every activity for teaching
or healing that illustrates the meaning of community as method.13’

Page 33 of 70
The Delaware Health and Human Services report noted the concern about the purpose for rules
within a women-based treatment program, when it observed
Many alcohol and drug treatment programs establish strict
rules with signiscant consequences m an effort to provide
structure for clients and, m turn,to affect behavior change.
Frequently, the rules and the consequences for non-compliant
behavior undermine the treatment process, particularly treatment
engaged, for women. Programs providing women-specific
treatment ensure that rules support and encourage women m
treatment. Similarly, consequences for non-compliant behavior
are relevant to women and, again, aimed at promoting treatment
retention and progress.133
Currently, clients must go through the hierarchy to gain access to a staff counselor. This practice
is designed to control the access of clients to professional M a s well as to utilize senior clients
whose job is to be an advocate for and listen to less senior clients and to help them deal with
issues and concerns. Although this practice has its purposes, both therapeutic and managerial,
Haslett “strongly” encouraged a modification to this practice, noting clients ‘’vVhosejob function
0 is to act as an advocate or active listener may not always understand, or adequately report, a
potential serious issue.”134
The program directors took some issue with this observation,
explaining that the pomt of having clients report to other clients is that m the world they are gomg
to be released to, they wont have a counselor to run to every day. The clients must learn how to
deal with peers without the need to run to counselors. One of the directors explained addicts
need to learn how to deal with people without resorting to an emotional crutch, either a counselor
or drugs. The point behind the “fimilf8milY”is to instill basic behavior skills, one of which is learning
how to deal with people and deal with people who are not doing right without running to
something to get comfort or validation.
As noted m the literature, one of the chief issues m gender appropriateness of a TC
program is women feeling “safe” in the program; safe to express their needs, emotions, past
histones of abuse and past behavior without fear of rejection or codiontation. Women, unlike
men, ‘‘bond” through conversation and cod?ontation is not a tool that positively makes changes m

Appropriateness of the KEY /CREST Program
Page 34 of 70
Men and women function differentlyin groups, as Haslett points out, “women seek
beha~i0r.l~~
connections through talk, while men seek connections through activities . . Women tend to build
on one another’s remarks whereas, men fiequently ignore or challenge others’ remarks.”136Men
tend to use codiontation m a hostile manner while women use colrlkontation in a supportive
manner “(e.g. ‘You need to tighten up and get your act together because you need to get home
and take care of your babies.’).’’137 Women tend to be motivated by the presence of children
while men are less motivated by children to succeed m treatment.138These differences are
signiscant when assessing the gender appropriateness of the CREST programs, which are co-ed.
Haslett assessed the presence of co-ed treatment as follows:
When interrupted or challenged by men, women tend to remain
silent.’39I believe [the TC program and StaffJ have overlooked
the degree to which encounter groups and the TC hierarchy may
inadvertently create an environment of male dominance associated
with earlier patterns of abuse [ d e r e d by the female clients].
The conl?ontational strategies used m the programs, often verbally
aggressive and hostile, as well as the overwhelming number of
males m the Crest program (better than a 7 - 1ratio of men to
women) and their predominance m the TC hierarchy, combme to
form a psychologicallythreatening environment for
Dr.Haslett concluded that because of the difference between men and women and the histories of
women within the criminaljustice system (having histories of negative male dominance and
abuse), “the Crestprogram should be a same sexprogram as is the REYprogram. Some
educationalprogramming could be coed, but the basic functioning of the TC houses and
groups should be same sex grouping.”’41Both the program participants and program staff
advocated a different view. As discussed below, the program clients asserted that it was a
positive experience to have co-ed treatment at CREST. The program directors also believed that
co-ed treatment did not have negative affects on clients. The program directors noted that
controlling the interaction is a “challenge” but that male and female interaction per se is positive.
One director did agree that there are some women who need to be m a smgle sex program and
many of the women need to participate in single sex sessions because they need to learn how to
have positive relationships with women.
Appropriateness of the KEY /CREST Program April 2002 Final Report
Dr.Haslett noted various observations and recommendations to Tnaximize the gender
0 appropriateness of the TC programs at Baylor and CREST. The chief recovendation was the
segregation of males and females m treatment group sessions and living arrangements. She noted
that the presence of men could, without intention, create a male dominated environment that is
antithetical to the TC concept model for women which is to create a “safe” environment for
contmuing the habilitation of the women. Dr.Haslett made other observations specific to Baylor,
chief of which was that the “general chain of command should be modiiied so there is a
recognized procedure for clients to have direct access to staff. Clients m ‘gate keeping’ positions
may not always exercise good Judgment m limiting access or m identifling Haslett
observed that although the current job descriptions and hierarchy are usell m meeting the
teaching and behavior control needs of the program, “each job function should be reviewed for its
therapeutic as well as ‘house management’ usefi~.lness.”’~~
Dr.Haslett noted the program appears to meet behavioral needs but needs to reassess
operations to meet more of the cognitive and emotional aspects of the TC model and needs of the
clients. One reason for this is the need for an update m TC c u r r i c b Haslett observed the
a following:
Each TC site has several volumes of curricular materials (e.g.,
curriculum outlines for various life skills, addiction, the disease
concept, ect.). However, these materials usually had to be
borrowed and the materials I looked at were dated (most
references fiom the 1 9 7 0 ’ ~1980’s
~ or early 1990’s). I believe
the resource materials available to counselors needs to be
updated and strengthened.lU
On this observation, the program directors agreed totally. They noted that the need for stafT
training is serious concern. In addition to a basic upgrade of the curriculum available to s a
there needs to be an integration of the TC curriculum and basic information on psychology.
“For women, there should be materials covered m an mtroductory psychology of women course
(e.g., self-esteem issues, sexual abuse, systemic discrimination, patriarchy, ect.). Such material .
. .would provide an overall framework for mtegratmg all the program information (i.e.,
information about patterns of criminality,job training, life skills, and so Haslett

Appropriatenessof the m Y / C m S T Program
Page36of 70
e recommended that the curricuhm cover areas including women’s health issues, sex speciiic anger
management (taking mto account that men externalize anger while women internalize anger and
how the differences matter) and how development of healthy relationships. Lastly, there needs to
be an overall integration of the curric- so that each topic builds upon what was learned m the
previous lesson rather than appearing to be a group of unrelated topics.’46On this observation, the
program clients were m agreement. Many of the clients noted that there is a disconnect between
various group sessions and the materials m each one. Some noted that the material m Merent
sessions is the same thus “they have heard all this before.” The program directors noted the issue
is not whether they have ‘%heard”it before but whether they have “learned” it before. The
distinction of course is between hearing and not mtegratmg the material mto one’s behavior and
hearing the material and mtegratmg it mto behavior.
One of the KEY aspects of the TC model is the use of encounter groups m which clients
are co&onted m regard to negative behavior. Haslett made several recommendations fix
improving interaction m the encounter groups. In particular, she recommended that
encounter groups have no more than twenty clients m
each group and that usmg hostility [venting] m the womens’
encounter groups be eliminated. Finally, the pradice of not
allowing clients to respond to criticism should be reconsidered,
at least m some confrontational settings. Clients should have
the opportunity to respond to criticism and learn how to do so
m a constructive
The program directors stated that although clients m some encounter groups can’t immediately
answer criticism m the encounter groups, they have avenues to respond. They can respond to
mdividual clients later m a session or they can respond m another session. The pomt of preventing
immediate response is to teach the clients how to take Criticism and reflect on it before
responding. The directors explained that addicts are accustomed to responding emotionally and
immediately without consideration of the nature of their response or the ramifications of the
response or even assessing ifa criticism is worthy of a response. By controlling the impulse to
respond without timely reasoned thought, the addicts learn to consider a criticism and then decide
how to respond ifat all.
@ Appropriateness of the KEY 1 CREST Program
Page 37 of 70
OveraJl Haslett did find that the Baylor / CREST programs m theory and program
implementation were gender appropriate for women. Her review found the I programs to have
bilities that were appropriate for women m the color of the walls and the ability of the women to
personalize their living areas. She noted that more space was needed at the CREST hilities.
The program had the support of program staff and DOC staff and the program was m line with
the general concepts of TC programs. She also noted that the c u r r i c b should be updated and
integrated mto one seamless contmuous program. The encounter groups need to further minimize i
the use of hostility (venting) as a mode of operation and allow clients to mteract more when
criticism is made. The two chief recommendations were:
(1) The co-sex structure m CREST does not assist women m habilitation and can be a
detriment to the gender appropriateness of the TC program
(2) The program at Baylor should
(4 Reevaluate the hierarchy structure to focus on the emotional and
psychological needs of the clients and the TC model rather than on the
behavioral control aspects
(b) Reevaluate the hierarchy structure to allow clients more direct access to
program counselors
Part Three: Assess client satisfaction

The current residents of the Baylor KEY program were interviewed m order to assess
what the c%mily”148
members thought of the program. There have been various changes to the
program between the time of 1999 graduates and the current “hdy’’ members. One of the main
changes has been the location of the program. The KEY program was moved to a new unit
divided mto four pods within the Women’s Correctional Institute. This change was si&cant to
the program design because the program was divided mto four mdependent pods rather than one
inclusive community. Previously, the program was a 42-member pod m which all of the women
were part of one community. The change m location allowed for the creation of four independent
pods m which each pod had 24 ‘%milf8milY
members.
” Each pod is self-contained with an
mdependent authority structure. Our interviews occurred aRer the changes had occurred.
0 During the Fall 2000 and Spring 2001, a survey was developed to assess how the current
‘‘fhdy“ members viewed the KEY program The questions were intended to gather information
to assess the gender appropriateness of the program, During the mterview period there were a
total of eighty-eight women m the KEY Program. Of the eighty-eight women, seventy-six women
agreed to participate in the survey. See tab three for a copy of the survey and IRB protections.
Of the seventy-six women who agreed to participate m the survey, h o s t 66% were
between the age of 18 and 35 years old. Afi.ican American women accounted for 57% of the total
population and Caucasian women accounted for 41%. The majority of women (63%) had
previous drug / alcohol treatment of which 73%had been in treatment between 1 and 3 times
prior to being placed m the KEY Program. The majority of ‘wy
members (83%) had no
prior experience at the KEY program. Of the 17% of ‘‘fhdy“ members who had prior KEY
experiences, the majority of them (69%) only had one prior experience with the KEY Program.
The confrontational aspect of the program allows for general confrontation (m which
behavior that is contrary to orderly operations of the pod are handled through sanction application
by superior ‘Ygmily’ members) and peer sessions m which a ‘Yktdf’ member is told about
behavior that is contrary to acceptable behavior or improvement m drug treatment. The majority
of the ‘‘hdy“ members (53%) approved of the confrontation aspect of the program, A minority
of ‘‘familf members did not approve of the conf+ontationalaspects of the program (32%) and
15% of the ‘%milffBmiy’ members had mixed opinions of the confrontation aspects of the program.
The difference m approval did not change when assessed by age, with the exception of ‘Wfy
members between the ages of 36 and 40 years old. More women m this age group (36 to 40)
disapproved of the confrontation aspects of the program than those who supported it; interviews
reflected that these women felt disrespected by the younger women’s criticism. The majority of
women (59%) thought the confrontational aspect of the program was appropriate for women.
The belief that the confrontation aspects were appropriate was evenly distriiuted by age, with the
exception of women between the ages of 46 and 50. Again it was the older women who had
concerns about the appropriateness of younger women bemg “disrespectfd” of older women by
Appropriateness of the KEY /CREST Program April 2002 F’inal Report
giving criticism in regard to behavior. There was clear consensus that the women considered the
conitontation aspects of the program helpfiil. A majority (61.8%) of the women Viewed the
conitontational aspects of the program helpfirl to them. The view that the conitontational aspects
of the program were helppll did not change when responses were viewed by age. Again, it was
found that the older women (46 - 50 years old) did not believe the conitontationalaspects of the
program were helpll to them.
One of the factors m assessing whether a treatment program is appropriate for women is
the assessment of whether women participating m the program feel safe &omabuse, physical,
emotional or s e d . To assess ifthe program at KEY provided feelings of safety, women were
asked about the rules of the program and the enforcement of those rules. A clear majority of
women (78.9%) considered the system of ‘Yiudf members bemg m positions of authority
appropriate. But an even higher percentage of women (96%) expressed the view that ‘Yhily‘‘
members had abused their authority. Interviews revealed that the new structure of four separate
twenty-four-member pods had d e changes m how promotion within the pod occurred.
Origmally, a “fhdy“ member had to earn a position of authority and there were more ‘Yamily“
0 members than positions of authority. In other words, there were more Indians than chie&. Under
the new structure, positions of authority are rotated among the twenty-fbur ‘w’
members.
Thus positions of authority are perceived not bemg earned. Because positions are given by
rotation rather than by merit, the opportunity and occurrence for abuse of authority was viewed as
mcreasmg.
The conclusion, that the high complaint rate of abuse of authority is based on the change
m how that authority is maintained by ‘‘fbdy” members (as opposed to a situation m which the
program itself is fostering an d e environment) is supported by other responses by the women
m the program. The majority of the women (90.8%) believed that the program rules are
appropriate, that the rules are helpfirl to the treatment process (86.8%), that sanctions for
negative behavior are appropriate (73.7%) and that is appropriate for other W
‘ 8
fmy
li”
members to
impose sanctions (72.4%). Agreement on the appropriateness of the sanctions remained when
reviewing responses by age. Across all age groups, the appropriateness of the program sanction
Appropriatenessof the KEY / CREST Program April 2002 F’inal Report
a structure was positively viewed.
As previously noted m the literature review section, one of the main issues with the
I
conversion of the TC model from male prisons to female prisons is the hoper use of
codiontation. Women respond differently to co&-ontation than men do and for a program to be
gender appropriate, the use of confrontation or hostility must be controlled. The TC model is
appropriate ifthe program is hir and not hostile. When the women were asked ifthe
codiontational aspect of the program was appropriate, sixty-four percent responded directly to
the question of codiontation. One quarter of the women (26.3%) approved of the cor&ontational
aspects of the program as long as it was not vindictive and forty (39.5%) percent of the women
noted that they did not approve of the codiontational aspects of the program, if the coni+ontation
was hostile. Eighteen percent of the women responded, m various ways, that the co&-ontational
aspect of the program had therapeutic value.
The women viewed the rules as helpll to treatment because they helped teach
responsibility, provided structure and instilled the idea that the world outside had rules that had to
be followed. The women also noted that the rules provided an opportunity to handle situations
that were not pleasant and learned how to control behavior. Analysis of responses to the
appropriateness of sanctions did not show any negative views of the rules. “Family“ members
having authority and imposing sanctions were supported because fellow ‘”f8mily” members are
more aware of behaviors of the fimily because they are around them 24 hours a day. The women
noted that the c%milly”runs the pods, so c‘fimilf’ members should impose sanctions. Staff sets the
rules for the pods so they are not arbitrary.
Part Four: Focus group analysis

There were a total of nine focus groups; six were conducted m CREST North and CREST
South and three at the KEY Village at Baylor. The goal of the focus groups was to assess how
the participants viewed the program with a specific focus on whether the program as implemented
was appropriate for women. The assessment of how the actual participants m a TC view the
program is important because the TC model is based on the concept that change is personal and
Page 41 of 70
e change under a TC is subjective to each participant. As DeLong explains:
The TC is behaviorally oriented but the process of change
l
is pnmmly understood by the participants themselves m
subjective terms, through perception and experiences.
Individuals not only must actively engage m the behaviors
and attitudes to be changed but must feel the feelings associated
with this engagement, understand the meaning or value of the
change, and come to see themselves, others, and the world differently.’49
Baylor Women’s Correctional Institute

The focus groups at Baylor divided the women into groups based on their time m
program; Group One had women who were m the program for up to 5 months, Group Two had
women who were m the programbetween 5 and 9.5 months and Group Three had women
between 9.5 and 13 months. Groups One had 7 participants, Group Two had 3 participants and
Group Three had 9 participants. Alison Rose conducted the three focus groups.
The focus group discussions focused on two main issues: the conkontational and
hierarchical structures of the program. The women m the hcus groups were almost uniform m
accepting the conkontational aspect of the program. They noted that the pomt of the
conkontation aspects of the program was to learn how to be held accountable fbr their actions.
The women were able to separate two things that the literature seems unable to separate; tone of
a conkontation fiom the substance of the conkontation. The women noted that they were not
intimidated by the tone of the codiontation or the fkct of the conf?ontation itseK They noted
that the conkontation was designed to m o w behavior, to teach them to be accountable for their
actions and be able to see past the tone of conkontation and receive information that would
benefit them. Many of the women noted that when they are confionted, they look for things that
are true to them and pay no attention to the rest. But m all cases they remained in control of their
behaviors. They were very cognizant that it is not the conkontation per se, but the response to
conkontation that matters. One woman noted that due to her famrly history of abuse, she did not
like the yelling aspect of the codiontation but noted that it had the purpose of making her
stronger m controlling her reactions.

ProcessEvaluation Assessing the Gender Grant Number 99 - RT - VX - KO16
Page 42 of 70
The hierarchical structure was less uniformly supported m that some of the women noted
that women higher m the hierarchy showed favoritism and that positions were given not m
accordance to time m the program Most of the women approved of the system because it
created a structure and maintained order. Many noted that the pomt of the positions was not
merit, but tools to teach members how to deal with responsibility and how to be compliant with
authority and not display negative behavior when corzfionted. Many of the women noted that the
pomt of the hierarchy and applied sanctions (whether justified or not) was to “just be alright with
it.” The hierarchical structure was seen as just another way to learn how to deal with things that
happen and submit to authority. One woman noted that if she is told to do something or told to
accept a sanction, the pomt is to “just do it“ and not to respond negatively. The women as a
whole did note that having addictsjudging addicts was a good idea Many of the women noted
that they would prefer more contact with and discipline by trained sM.
CREST North
Three focus groups were held at CREST North (orientation, primary and work release).
The orientation group was composed of ten males (there were no females m the orientation phase
of the program during the time of focus group creation) six of whom were white and four were
black. The primary focus group was composed of three females and seven males; of the ten
participants five were white, four were black and one was Hispanic. The work release focus
group was composed of three women, f i e men; of the eight participants four were white and four
were black. The work release participants had been m the program between two and six months,
the orientation participants had been m the program between ten days and one month and the
primary participants had been m the program between one and halfand four months.
The women m the primary group agreed that the program was not good for women. They
noted that the reason was not because of the presence of men m the program but because the
program does not allow for the women to ‘ k n d together” or provide program events that are
gender specific to women. They noted that the program does not have programming that allows
the women to have closer and more frequent contact with hmdy members to repair burned
e Process Evaluation Assessing the Gender

Appropriatenessof the KEY / CREST Program
Page 43 of 70
bridges. They noted that there are no “women or mother” days that are designed specifically for
0 the emotional needs of women. Some of the men agreed and noted that the M e r s should also
have father days to mend relationships with their children. The program directors noted that there
are presently programs that allow for these types of days. There is a system wide program called
Kids Connection, which is operated by a non-profit organization that picks up family m e m h
throughout the state and brings them to the prisons m order to allow family members to mend
relationships with family members. Two of the program directors noted that they have programs
that have family days are set up m which barbeques and other events are organized to allow for
family bonding with program clients.
In regard to the codiontation aspects of the program all three focus groups agreed that it
has very little therapeutic value and that the yelling m the cofiontation groups was not helpll.
One of the concepts behind the TC program is the concept of “the fbdy“ m which each “hnilf’
member has responsibilities to the family and the TC provides behavior modification through a
‘‘fiimilf’ structure akin to how a regular family operates. There was universal agreement that the
“bonding” that occurs m a family environment is discouraged. Many of the group participants
0 noted that “bonding” does not occur because a close fiendship can be used as a basis for program
fidure and bemg returned to prison. The program directors agreed that the ability of clients to
make and build relationships is limited and controlled m order to prevent inappropriate sexual
relationships (both heterosexual and homosexual). They did not agree that fiendships can not be
made, but noted that many of the clients do not have a stable and healthy view of what a positive
and appropriate relationship is. They noted that due to dependency issues, many of the
relationships are made m order to escape the need to deal with serious emotional and behavioral
issues. The program directors noted that the truth is that the clients’ behavior m regard to
relationships is controlled not discouraged.
Two out of the three focus groups were comprised of males and females. It was observed
that the males did not intimidate any of the women m the group fiom voicing their opinions nor
did they stop functioning (shut down) when a male disagreed with them. The women were asked
if other women m the groups shut down and they noted that some of the women shut down but
Page 44 of 70
that was because they did not want to speak m the first place, rather than being intimidated by
men. Both males and females noted, that recovering addicts need to be around the opposite sex m
order to learn how to relate to the opposite sex without sexual overtones and behaviors. The
presence of the opposite sex, they noted, is also needed for ‘‘knily members” to learn how to
form friendships with the opposite sex and to see the opposite sex m a positive light. Many of the
group members noted that this type of bonding is discouraged and needs to be encouraged. They
agreed that it should be monitored and controlled, but not discouraged. I
The focus groups agreed on two other factors of the program; first that there was a lack
of organization between the DOC staff and the TC counselors, and second, that the program was
sufferingbecause too many people in the program were forced to participate, which reduces the
therapeutic aspects of the program. In regard to the people in the program, many of the focus
group members explained that the whole farmly could ‘hy” a sanction based on the behavior of
one f k d y member. The pomt of a ‘%ufyis to have all suffer for one to build group
responsibility. One M y member explained the therapeutic value of a “buy”. He explained that
the goal is to bring home to the addict that the negative behaviors that an addict commits impacts
0 others. He explained that he was a drug user and dealer and he was staying m the home of his
girlfriend who was not involved in the drug trade. The police found drugs m her house and she
was convicted of drug possession. He explained that ‘kcause of my foolishness” she can’t get
jobs that can support her and her children. He said she suffered for his actions and he came to
grasp the impact of this through experiencing sanctions through a “buy”. He said addicts don’t
consider how they &ect others, a ‘%uf’ teaches that by having clients suffer for the acts of
others.
One problem noted was that some members of the “Eudf’just went through the motions
and did not desire to change. It was noted that the therapeutic value of a ‘‘buy’’is lost when a
clients does not care about receiving a sanction or the fact that others receive the same sanction.
If the” f8mily” member does not want to be m the program (or is forced mto it) and does not want
to change, the value of a ‘hfY
will be lost. One participant noted that too many people are m the
program because they can get an early release by completion. This participant said that the
Proms Evaluation Assessing the Gender -
Grant Number 99 - RT VX - KO16
Page 45 of 70
e program should not promise release time nor should it be open only to those close to release. The
program should be open to anyone who wants to deal with hisher addiction but participation
should not have the benefit of early release. He noted that the motivation should focus on getting
clean and dealing with addiction. One participant noted that if the motivation of participating in
the program is gettmg over an addiction and not early release, the program would be smaller and
would work better. Other focus group members agreed with this assessment. All of the focus
group members were m agreement that the addict has to want to change before this program or
any other will make any difference. They noted that the program has too many people and too
many people who don’t want to change and that these two factors are reducing the value of the
The focus groups were not without compliments for the program. All three groups noted
m different ways that the program provided a way to reflect on behavior. One participant noted
that the program allowed him to learn how to watch his behavior and think about domg or saying
something before he does it. A different focus group member noted that the whole pomt of the
sanction process is to teach people that not everything is gomg to go their way and they have to
0 learn to be all right with it. It was also noted that, “the program teaches the addict how to control
his emotions when things don’t go right.” One participant noted that he learned how to take time
and reflect over the day and ask himself‘tvhat can I do tomorrow better than what I did today?”
Other participants agreed with the observation made by another participant that the program
allows addicts to “appreciate the simple things m life - grass, trees, bemg outside - without drug
use.” It was noted that the program “ln-ings people to acknowledge what they have done and that
they have a problem” and that the program will make a positive difference m behavior simply
because it requires one to think about behavior and the consequences thereof As one participants
noted, the program “-bringshome the point, don’t cry now; you should have stayed home”
meaning “you did the crime and ended up here.”

Page46of 70
a CREST South
The CREST South program is a modified TC program m that it shares facilities with a
non-programmatic work release program and is on the campus of the Sussex Correctional
Institute (a level 5 prison). A Level V +on is one in which the facility is secured and prisoners
do not have the capacity to leave. Level V prisons hold people who sentenced to more than one-
year incarceration for the commission of misdemeanors or felonies. The CREST South program is
within the Department of Corrections (DOC) facility. Many of the security operations and
procedures that CREST South uses are imposed by DOC and not by the TC programmatic staff.
The three focus groups included 15 males and 17 females. Of the total participants, 19
were black and 13 were white. Group one, orientation, was made up of 10 participants of which 4
were males and 6 were females; 6 Participants were white and 4 were black Group two, primary,
was made up of 9 participants of which 5 were males and 4 were females; 7 participants were
black and 2 were white. The third group, work release, was made up of 13 participants of which 6
were males and 7 were females; 7 participants were black and 6 were white.
All three groups noted that the ”hostility“ of the program was not helppll to treatment.
0 Both males and females reflected on how one participant d e s m i d the hostility as not bemg
helppll because it involves “breaking down, but no building back up.” The group participants
noted, as did members of CREST North, that the program has too many people who are
sentenced rather than those who want to be m the program. One CREST South participant noted
that the only thing the program taught was “how to be more sneakier” m behavior. There was
d o r m agreement that the program is behavior modification based, not treatment based. It was
voiced clearly that the program does not focus on drug treatment and education but on sexually
transmitted diseases and behavior modification. One participant noted that people who come “off
the street” to CREST South rather than fkom a KEY program (Baylor or Gander Hill) are at a
disadvantage because they don’t have the exposure to drug addiction education and treatment or
how addiction affects the body or the mind. Many of the females, m addition to the males, noted
that the facility builds a desire “to use drugs” due to the environment. Another participant noted
that the program fosters an “act as if“ mentality and the desire go through the motions to get
Page47of 70
through the program. When an addict “acts as if’ the addict is actmg like he/she is learning
something fiom the program or is otherwise benefiting fiom the program, but m truth the addict is
just biding time until release and is not making any real change due to participation m the
pro€?-
One of the chief observations fiom the focus groups is that DOC runs the program and not
the counselors or the ‘ T h d f ‘ . DOC handles security and can override counselors or the “fhmilf’ /
on any matter it deems necessary. The stafYfkom CREST South took issue with this assessment. I
They explained that when it comes to security’ DOC sets certain rules, but the day-to-day
operation of the program is not under DOC control. Staff noted that CREST South in on the
campus of a DOC k i l i t y and it is faJr to say that the CREST South program is not m a dedicated
treatment kility. Staffnoted that they share kilities with non-CREST inmates and don’t have
complete separation fiom DOC inmates; it is not true that DOC officers override staff m regard to
CREST operations. The CREST South staEalso noted that they enjoy the 111 support of the
warden and that ifthey did not have it, then they would have serious problems. The other project
directors agreed that DOC is m charge of security issues and their facilities are not treatment
dedicated, but that they also enjoy the 111 support of the warden. It was admitted by the project
directors that there are some DOC officers that want to treat the ‘‘fimily’’ members as prisoners
and not as people who are in treatment. The directors noted that when such officers-are too
heavy handed they have avenues to deal with the officers through the DOC and the wardens.
CREST South staff noted that one problem they have is the officers that work in the VOP
(Violation Of Probation) center (which is on the same campus) also work in CREST South and
sometimes these officers have to be reminded that the two populations are not to be treated the
same. The VOP clients are intentionally handled with a hard hand because they are probation
violators.
When the women were asked what impact having males in the program had on them, the
majority noted that it was positive. Many of the women felt that it was safer to disclose personal
information to men than to women. When asked why, m y noted that men would keep the
information to themselves while women will talk about confidential information with other
Process Evaluation Asswing the Gender Grant Number 99 - RT - VX - KO16
Page48of 70
women. The program directors had an interesting response to this observation. One project
director explained that the “person who said this must be m an immature place in her treatment”
and a counselor explained “women seek relationships with men so as to see who they can get
with.” The project directors and counselors explained that women avoid dealing with other
women because other women can see through their “manipulation” and see directly into what
problems they are trying to hide. In other words, they seek male support because the males can’t
or won’t see through them and that the men can be open to manipulation. When asked why would
a women, presumably sexually abused, go and tell a group of men about the abuse and not other
women; the program directors and staffexplained that women who are abused are used to going
to men to get comfort. The comfort can be negative or positive, but the behavior is still going to
men for support. They have not learned to build positive relationships with other women and as
such don’t want to seek their supp~rtin treatment. This is why they feel more comfortable with
men. The program directors explained that the women not wanting to talk with other women has
less to do with other women not holding secrets than women not wanting to be held accountable
for behaviors that lead to their addiction and criminalbehavior. Thus being held accountable
occurs with other women more than with men.
Other women m the focus groups noted that they came fiom all female facilities (violation
of probation center (VOP) and /or Baylor) and bemg around males was a positive thing. Some
women noted that they would prefer more smgle sex seminars but there was no general
disapproval of being m a facility with men. They noted that they desired to have non-sexual
relationships with men. One male noted that the presence of women allowed him to learn how to
approach women with respect and without a sexual motive. Many of the other males m the
groups agreed with this statement. They noted that the program staff spends too much time and
effort trying to catch males and females m inappropriate behavior rather than fostering healthy
relationships between males and females.

Proceais Evaluation Assessing the Gender -
Implemented at the Baylor Women’s Correctional Institute Page49of 70
e Analysis and Discussion
Both the KEY program at Baylor and CREST North and South programs are designed to
habilitate ‘ Y d y ” members. The CREST orientation manual I5O makes it clear that the CREST
program is based on the philosophy that people who engage in long-term criminal activity and
substance abuse need to be “habilitated” not rehabilitated because, as noted in the KEY
orientation man~al,’~’
addicts never developed the social skills that society takes for granted. Both
programs implement the therapeutic community model using the rational authority which
presumes that the “client population needs discipline, direction, education and training in order to
elicit pro-social change.”153The KEY / CREST programs are in line with the literature on the
concept of a TC. As Bouffard and Taxman summarized the literature:
The traditional therapeutic community (developed and
reihed on samples of male participants) is designed as
a total-milieu therapy approach, promoting the development
of pro-social values, attitudes, and behaviors through the use
of a positive peer culture. ... Contemporary TC’s emphasize
a the use of the therapeutic milieu (i.,e., treatment group) to

retrain addictloffenders toward pro-social value systems by
combining cognitive behavioral models with traditional
group-based, confi.ontationa1techniques. TC’s emphasize. . .
the reliance on the peer group itself as an agent of therapeutic
change. The clarification of vahes has also been an important
tool of the TC, integrating the substance abuser back into
conventional society through the adoption of mainstream values. 154
The vehicle for this habilitation of social skills that were not learned during childhood is “a family
type environment, a self-sustaining and self-perpetuating Therapeutic Community [in which the]
Director is an authority figure who, along with the intervention of the staff,attempt to re-parent,
giving the clients the direction, nurturing and discipline that they may not have been given to them
in the past.”155
Both programs allow for “ f d y ” members to be promoted along a rigid authority
structure in which the top position is the program coordinator and the lowest is the service crew.

Page 50 of 70
The positions within the KEY Village and CREST programs are therapeutic m nature, m that they
are designed to build upon positive behavior and teach responsibility and discipline. Positions
within the authority structure can be given or taken away to build upon developed positive
behaviors, to help the ‘‘hdf’members deal with success, fidure and what they call “an mkt.”
An “mjust” is short for an injustice suffered by a family member. The pomt of an “mmt” is
learning how to deal with an event (such as a demotion or a Mse accusation) that is not hir. The
goal of an “mjwt” is teaching the c‘hnilf8mily”
member a fundamental truth of society; not everything
is gomg to go your way and when it doesn’t you have to learn how to deal with it and move
In other words, an “ m k t ” is designed to test a ‘%mily” member’s behavior to negative
experiences and to teach that things happen and that “you’re supposed to be O.K. with it.”157
Another ‘Ykdy“ member explained that an “mwexposes
’ addicts to the feeling of d & g for
the mistakes or behaviors of others.
The CREST North and South programs are primarily behavior modification m approach.
The program staffview behavior modification as treatment. The CREST ma
nua
s
l are devoted to
the behavior modification aspects of a TC program CREST North is housed m a quasi-
@ mdependent facility, thus it has less DOC participation m the program than CREST South. Both
programs are crowded. One of the observations made during the focus groups at CREST North
is that the facility is loud. Announcements have a very high decikl pitch. When asked about the
loudness of the f$CZty,both males and females explained that is so things can be heard.
Apparently, the high decikl sounds did not affect the participants as much as the mtewiewer.
While CREST North is housed m a self contained house that does not appear to be a DOC facility
fiom the outside (its located m a residential area of the City of Wilmington), CREST South m on
the campus of the Sussex Correctional Institute and as such has more contact with DOC prison
guards. The difference is readily apparent. At CREST South, for example, it was observed that
during a count (when inmates are counted to make sure an escape has not occurredand everyone
is accounted for) male DOC guards walked mto the rooms of female inmates without knocking or
announcmg. This by itselfis a small thing, but there is a gender difference between a male guard
walking into a room of male inmates and a male guard walking into a room of female inmates. In
(I) Appropriateness of the KEY /CREST Program
Page 51 of 70
CREST North, on the other hand, senior ‘‘fkdf’members conduct the count for the house.
Both CREST North and South focus group participants made it clear that the program
I
had too much hostility and had StafTspending too much time ‘‘stalking” Emily members in regard
to co-ed relationshp. Many of the partic;Pants made it clear that the co-ed facilities allowed for
learning how to form positive relationships with the opposite sex and that the presence of the
opposite sex had therapeutic value simply because “its nice to see the opposite sex” after being
with just males or females. They accepted that controls have to be made to prevent iuappropriate i
behavior, but the participants voiced concerns that the staff establishes so much fear about
relationshtps that the participants don’t seek to establish them due to fear that they will be sent
back to prison or the VOP center. The program directors explained that what the clients called
“stalking’ was proper monitoring of the clients. They noted that since addicts have a history of
forming negative and unhealthy relationships, they don’t know what a healthy relationship is. Thus
their relationships are controlled
Both the males and females made it clear that the program was too hostile and that there
was more ‘’tearing down than building up.” The program was observed to have a structured
0 atmosphere m which rigid protocols are used to address people in authority. It was observed that
m Baylor, the housing units were decorated to personalize the atmosphere and it is obvious
women live there. There were pictures on the walls, posters with pictures of children, and bad a
less ‘’prison look” than one would expect m a prison. CREST South has a more sterile
appearance. CRET North has less of a sterile appearance but the h d i t y is crowded
As noted m the review of the literature, women have various behaviors and histories that
require programmatic adjustments to make a TC gender appropriate.158
In general, men turn their anger outward while women turn
their inward. Men tend to be more physically and sexually
threatening and assaultive while women are more self-abusive
and suicidal (women make more fiequent but less lethal suicide
attempts, and actually commit suicide less often than men).
Women tend to engage m self-mutilatmg behaviors such as
cutting as well as verbally abusive and disruptive

Page 52 of 70
e Reed explains that
The dynamics that have been just d e s m i d are more extreme
versions of general Werences m coping between women and
men withia the larger society. Men are more likely to externalize
responsibility for Mures and take credit for successes; they will
try to minimize vulnerable feelings and take charge of their lives
until they can no longer do so. Women often attriiute success
to but take responsibility fbr Wures. They look internally
first for sources of their problems, and often feel powerless to
afEect their lives. [within drug dependence treatment programs
there is much less knowledge or about and experience with techniques
that are more usem for patterns that are more typical ofwomen.’@‘
Due to these differences m males and females, Dr.Haslet161asserted that co-ed TC

programs are inappropriate for women because women shut down when confronted by males and
that women with drug addiction problems also tend to have prior sexual abuse histories that are
exacerbated by the presence of men. Other researchers on TC’s have noted similar concerns.
Finally,treatment approaches need to be varied based on the
gender of the client. For example, many male drug treatment
models (especially TC’s)include confrontational techniques
designed to break down clients’ resistance to change and to
challenge their preexisting, drug-supportive belie& and
attitudes. The appropriateness of these approaches fbr female
clients, many of whom have experienced severe physical,
emotional, and sexual abuse, has been questioned.16’
This evaluation did not find these concerns expressed by the women (or men) m this study
or the program staE for Key, CREST South or CREST North. It was noted that co-ed treatment
was a b e f i t to them, for it provided opportunities to develop healthy and positive attitudes and
behaviors towards the opposite sex. The conclusion that co-ed substance abuse treatment is not
detrimental to women is also noted m the literature. For example, Stevens, Arbiter and Glider
made the following conclusion after conducting an evaluation on a TC program m Arizona:
Implications of this research suggest that women residents
may play an important role m mcreasmg the effectiveness
of substance abuse treatment for men and women. If women
m treatment are allowed to feel safe m addressing their
Process Evaluation Assessing the Gender -
Grant Number 99 RT - VX - KO16
Page 53 of 70
e treatment issues and demonstrate self-disclosure,treatment will
be more successfbl not only for women but fbr men as well.
Residential substance abuse treatment centers should strive to
equalize the male/female resident ratio. Staff training should be
given focusing on the special needs of women residents and
how involvement of women residents can increase program
effectiveness.163
The women (in CREST North and South) who voiced the view that the program was not gender
appropriate stated that the reason was not due to the presence of men or that they felt unable to
speak with men m the room. They voiced it was not “good for women’’ because the program did
not have enough gender seminars, that it has too much hosthty, too much behavior modilication
and too little drug treatment. Exchanges of disagreement between males and females were
observed and the presence of fear or feeling uncodortable on the part of the women (n=23) when
disagreements occurred was not observed. The women were found to be able to hold their
positions and views in the face of male and female disagreement. Many of the women made it
clear that drug treatment programs needed to have the opposite sex in order to develop healthy
a relationships and behaviors towards the opposite sex.

As previously noted’64there are various fktors that make a TC appropriate ibr women.
The program must address the whole woman in that her addiction, past criminalhistory, history of
sexual abuse, as well as her emotional and behavioral patterns need to be addressed.
Additionally, the program must consider the social context that women who have drug additions
come fiom.
In the past 20 years, theorists and researchers have identified
the importance of social context when explaining the behaviors
of mdividuals. The choices of the individual are seen as shaped
by a combination of social, cultur4 and economic factors.
Gender-specific interventions must be based on an understanding
of a woman’s social relationships and be applicable to her social context.’65
TC program and staffneed to keep m mind that drug addiction is not a smgle issue involving the
use of a particular drug or the use of drugs that lead to antisocial behavior. The TC model
presumes that drug addiction is the reflection of dyshction m an mdividual not the dysbction
Page 54 of 70
of the mdividual. The use of drugs has a social context that is different m women and men. TC
0 programs that are gender appropriate take mto account the social and cultural factors of life that
have differential impact on men and women. As Reed points out,
it is very important to develop regular m-service training
sessions that can he@ staff learn as much as they can about
their own mdividd and collective culture, and about other
cultural patterns. [Because counseling] is a transaction m
which each person is affected by the characteristics and
communication style of the other.'&
There are social contexts to many behaviors. Some of these contexts have different results
on women than on men. Put simply, women have different social contexts m regard to drug use
and drug treatment and TC programs need to take these differences mto account m order to be
gender appropriate. Part of understanding differential social context of drug addiction for women
is that all women m drug treatment programs are not the same. Women enter drug treatment
programs with various histories, drug addictions, life experiences, educational (literacy) levels and
cultural backgrounds at Merent stages of their lives. Males and females have diffaences m drug
histories and life histories and the design and implementation of drug treatment programs should
be allowed to recognize these differences.

Process Evaluation Assewing the Gender -
Page 55 of 70
a Recommendations
1. A review should be conducted on how people are placed in CREST North

and South.
Currently a person can be placed in CREST North or South by court order, as a
condition for release fiom Baylor or Gander Hill or by request by an inmate
without being required to go through the KEY program. The program needs to
have a reduced number in order to end the “crowded” aspect of the program and
include inmates who “want” to make a change in their lives. Inmates who are
placed in CREST North or South under order and who don’t want to be there take
away fiom the therapeutic nature of the program.
2. Both Dr. Haslett and the program directors agreed that the more outside
training for the staff is needed. The curriculum should also be reviewed to
make sure that it is current and that it is relevant to drug treatment
programming and gender appropriate.
3. An assessment is needed to determine what actually needs to change to

improve the environment and therapeutic value of program operations and
what views from the “family” members are based on the negative behaviors
of addicts and people who are incarcerated. The meetings with family members
and program staffmade clear that there are various differences of opinion as to the
quality and nature of what is treatment and whether the program offers ‘ Y d y ”
members an environment for positive change. It is not proposed that the program
does not provide such an environment but that the “family” members perceive it as
not being a positive environment. Although the program was found to be gender
appropriate, there appears to be Merences in what the program directors and
counselors define as treatment as compared to what the “family“ members define
as treatment. This is signijicant because research has shown thatpeople in
treatment are more successful when they view program modality as treatment.I6’
Report to the National Institute of Justice Delaware Criminal Justice Coundl

ProcessEvaluation Assessing the Gender Grant Number 99 - RT - VX - KO16
April, 2002 Final Report
Page 56 of 70
‘Garrison, A. (1999). SODAT - DELAWARE INC. NALTREXONE ALTERNATIVE PROGRAM (SNAP)
A HEROIN ADDICT OUTPATIENT TREATMENT PROGRAM: AN OUTCOME EVALUATION. Delaware
Criminal Justice Council: Wilmington, Delaware. Ganison, A. (2002). Drug Treatment Programs: Policy Implications
for the Judiciary. COURT REVIEW THE JOURNAL OF THE AMERICAN JUDGES ASSOCIATION 38(4) (In
Press).
*In 1999, approximately6.3 million adults - 3.1% of the Nation’s adult population - were under correctional
supervision (that is, incarceration,probation or parole). Drug offenders accounted for 21% (236,800) of the State
prison populatioh in 1998, up fiom 6% (19,000) in 1980, and 59% (55,984) ofthe Federal prison population in 1998,
up fiom 25% (4,749) in 1980. Also, in 1998, an estimated 26% (152,000) of all inmates under local supervision were
incarcerated for drug offenses. This increase in the drug offender prison population mirrors the steady increase in arrests
for drug offenses. Office ofNational Drug Control Policy (March 2001). DRUG TREATMENT IN THE CRIMINAL
JUSTICE SYSTEM FACT SHEET at 1.
In 1998, Americans spent an estimated $66.5 billion on illicit drugs:
$39 billion on cocaine
$12 billion on heroin
$2.2 billion on methamphetamine
$1 1 billion on marijuana
$2.3 billion on other illegal drugs
Rhodes, W., Lane, M., Johnson, P and Hozik, L. (2000). WHAT AMERICA’S USERS SPEND ON ILLEGAL
DRUGS, 1988 - 1998. Office ofNational Drug Control Policy at 4.
@ 74 million Americans have tried an illicit drug at least once in their lifetime, 2.4 million have tried heroin at
least once in their lifetime, 22.1 million have tried cocaine at least once in their lifetime and 4.6 million have used crack
at least once in their lifetime. Office of national Drug Control Policy (1998). DATA SNAPSHOT: DRUG ABUSE IN
AMERICA 1998 at 32-33
The impact of this increased use of drug use can be seen in the hct that the number of Americans incarcerated
(prison only) reached more than one million (1,078,542) in 1995 for the first time in U.S.history. Garrison, A. (2002).
Drug Treatment Program: Policy Implicationsfor the Judiciary, Supra note 1.
see dso, Chesney-Lind,M. (199 1). Patriurchy, prisons, andjails: a critical look at trends in women ’s
incarceration. THE PRISON JOURNAL 7 (1): 5 1 - 67, Henderson, D., Schaeffa, J. and Brown, L. (1998). Gender-
Appropriate Mental Health Services for Incarcerated Women: Issues and Challenges. FAMILY AND COMMUNITY
HEALTH 21 (3): 42 - 53.
Hooper, R., Lockwood, L,and Inciardi, J. (1993). Treatment Techniques in Corrections-Based Therapeutic
-
Communities. THE PRISON JOURNAL 73 Sept. / Dec. (3-4): 290 306; Rawlings, B. (1999). Therapeutic
-
Communities in Prisons. POLICY AND POLITICS 27(1): 97 111; Inciardi, J. and Scarpitti, F. (1992).
THERAPEUTIC COMMUNITIES IN CORRECTIONS: AN OVERVIEW, Presented at the Annual Meeting of the
-
academy of Criminal Justice Sciences, Pittsburgh, PA, March 10 14; Wexler, H. and Love, C. (1994). Therapeutic
Communities in Prison (18 1 - 208), in T h , F., DeLeon, G., and Jainchill, N. (Eds) THERAPEUTIC COMMUNITY:
ADVANCES IN RESEARCH AND APPLICATION,National Institute on Drug Abuse: Rockville, Maryland, and
Wexler, H. (1995). The Success of Therapeutic Communitiesfor Substance Abusers in American Prisons. JOURNAL
OF PSYCHOACTIVEDRUGS 27(1) Jan.-Mar.: 57 66. -

Pracess Evaluation Assessing the Gender Grant Number 99 - RT - VX - KO16
Page57of 70
DeLong, G. (1997). Therapeutic Communities: Is There an Essential Model? (3-18, at 4) In
COMMUNITY AS METHOD: THERAPEUTIC COMMUNITIES FOR SPECIAL POPULpTIONS AND SPECIAL
SETTINGS, DeLong, G. (Ed.). Praeger: West Port, Conn.
5
Ibid. at 4-5.
Ibid. at 4.
Ibid.
I
Supra note 3 and DeLeon, G. (1 985). The Therapeutic Community: Status and Evolution.
-
INTERNATIONAL JOURNAL OF THE ADDICTIONS 20: 823 844; DeLong, G. (1997). Therapeutic
Communities: Is There an Essential Model? Supra note 4; Inciardi, J. (1993). DRUG TREATMENT IN PRISONS,
Presented at the 1993 Summit on U.S.Drug Policy, U.S.House of Representatives, Committee on the Judiciary.
Washington, D.C., May 7; Lockwood, D., Inciardi, J. Butzh, C., and Hooper, R (1997). The Therapeutic Community
-
Continuum in Corrections (87 96), in DeLeon, G. (Ed) COMMUNITY AS METHOD: THERAPEUTIC
COMMUNITIES FOR SPECIAL POPULATIONS AND SPECIAL SETTINGS. Greenwood Press: Westport,
Connecticut.
lo Inciardi, J. (1993), Drug Treatment in Prisons, Supra note 9. See also, Pan, H., Scarpitti, H.,Inciardi, J.,
-
and Lockwood,D. (1993). Some Considerations on Therapeutic Communities in Corrections (30 43), in Inciardi, J.
(Ed) DRUG TREATMENT AND C R M I N U JUSTICE. Sage Publications: London, England, and DeLeon, G. (1997).
Therapeutic Communities:Is There an Essential Model? (3 - 18) in DeLeon, G. (Ed.) COMMUNITY AS METHOD:
THERAPEUTIC COMMUNITIES FOR SPECIAL POPULATIONS AND SPECIAL SETTINGS. Greenwood Press:
Westport, Connecticut.
11
Hopper, R., Lockwood,D., and Iinciardi, J., (1993), Treatment Techniques in Corrections-Based
Therapeutic Communities, Supra 3 at 29 1.
12
Ibid. at 295.
l3 Inciardi, J. (1993). Drug Treatment in Prisons,Supra note 9 at 3-4.
l4 Lockwood, D., McCorkel, J. and Inciardi, J. (1998). Developing Comprehensive Prison-Based Therapeutic
Community Treatmentfor Women. DRUGS AND SOCIETY 13 (1-2): 193 212,195. -
l5 Inciardi, J. and Scarpitti, F. (1 992), Therapeutic Communities in Corrections: An Overview, Supra note 3.

Proteas Evaluation Assessing the Gender Grant Number 99 - RT - VX - KO16
Page 58 of 70
0 -
l6 Ibid at 13 14. See also, Graham, W. and Wexler, H. (1997). The Amity Therapeutic Communityprogram
-
at Donovan Prison: Program Description and Approach (69 96), in DeLeon, G. (Ed) COMMUNITY AS
METHOD: THERAPEUTICCOMMUNITIESFOR SPECIAL POPULATIONS AND SPECIAL SETTINGS.
Greenwood Press: Westport, Connecticut, and DeLeon, G. (1994). The Therapeutic Community: Toward a General
Theory and Model, M a note 20.
l7 Inciardi, J. (1 993). Drug Treatment in prisons, Supra note 4; Hooper, R., Lockwood,D., and Inciardi, J.,
Treatment Techniques in Corrections-Based Therapeutic Communities Supra note 3; and Inciardi, J., Lockwood, D.,
and Martin, S. (994). Therapeutic Communities in Corrections and WorkRelease: Some Clinical and Policy
-
Considerations (259 267), in Tims, F., DeLeon, G., and Jainchill, N. (E&) THERAPEUTIC COMMUNITY:
ADVANCES IN RESEARCH AND APPLICATION, National Institute on Drug Abuse: Rockville, Maryland
Hooper, R., Lockwood, D., and Inciardi, J., Treatment Techniques in Corrections-BasedTherapeutic
Communities Supra note 3 at 292. See also, DeLeon, G. (1994). The Therapeutic Community: Toward a General
-
Theory and Model (16 53), in Tims, F., DeLeon, G., and Jainchill, N. (E&) THERAPEUTICCOMMUNITY:
ADVANCES IN RESEARCH AND APPLICATION, National Institute on Drug Abuse: Rockville, Maryland
l9 Hooper, R., Lockwood,D., and Inciardi, J., Treatment Techniques in Corrections-Based Therapeutic
Communities Supra note 3 at 292.
20
Ibid
21
Ibid.
22
Ibid. at 296.
23
Ibid at 292.
24
Ibid.
25
Ibid
26
Ibid. at 292 - 293.
27
Rawlings, B. (1 999), Therapeutic Communities in Prisons, Supra note 3.
28
Ibid. at 100.
29 Inciardi, J. (1 993). Drug Treatment inprisons, Supra note 4; Hooper, R., Lockwood,D., and Inciardi, J.,
Treatment Techniques in Corrections-Based Therapeutic Communities Supra note 3; Inciardi, J. and Scarpitti, F.
(1992), Therapeutic Communities in Corrections:An Overview, Supra note 3; Rawlings, B. (1999), Therapeutic
Communities in Prisons, Supra note 3; and Lockwood,D., Inciardi, J. B~ltzin,C., and Hooper, R. (1 997). The
Therapeutic Community Continuum in Corrections, Supra note 9.
Page 59 of 70
a 30 Hooper, R., Lockwood, D., and Inciardi, J., Treatment Techniques in Corrections-Based Therapeutic
Communities Supra note 3 I
Rid. The “Peer encounter is the cornerstone of group process in the TC. The encounter group uses vigorous
confrontational procedures as a mechanism for heightening a resident’s awareness of the images, attitudes, and conduct
that need to be modified. As such, the focus of the encounter is on behavior, with material drawn fiom peer and staff
observations of the resident’s daily conduct.” Inciardi, J. and Scarpitti, F. (1 992), Therapeutic Communities in
Corrections: An Overview, Supra note 3 at 4.
32 Inciardi, J. and Scarpitti, F. (1992), Therapeutic Communities in Corrections: An Overview, Supra note 3 at
I
2-3.
33 Inciardi, J., Martin, S., Lockwood, D., Hooper, R., and Wald, B. (1992). Obstacles to the Implementation
and Evaluation of Drug Treatmentprograms in Correctional semngs: Reviewing the Delaware KEYExperience (176
- 191) in kuketeld, C. and Tims, F. (Eds) DRUG ABUSE TREATMENTIN PRISONS AND JAILS. National
Institute on Drug Abuse: Rockville, Maryland
34 Lockwood,D., McCorkel, J., and Inciardi, J. (1998). Developing Comprehensive PrBon-Based

Therapeutic Community Treatmentfor Women, Supra note 9. See also, McCorkel, J., Harrison, L., and Inciardi, J.
(1998). How Treatment in Constructed Among Graduates and Dropouts in a Prison Therapeutic Communityfor
Women. JOURNAL OF OFFENDER REHABILITATION 27(3/4): 37 59. -
35 Stevens, A and Glider, P. (1 994). Therapeutic Communities: Substance Abuse Treatmentfor Women (162-
1go), in Leuketeld, C. and Tims, F. (Eds) DRUG ABUSE TREATMENT IN PRISONS AND JAILS. National Institute
on Drug Abuse: Rockville, Maryiand.
36
Ibid.
37 hid. at 173. See also, Wdck, C. and Evans, J. (1997). A therapeutic Community Program for Mothers
and Their Children (143 - 159), in DeLeon, G. (Ed.) COMMUNITY AS METHOD: THERAPEUTIC
Connecticut.
38 Stevens, A and Glider, P. (1994). Therapeutic Communities: Substance Abuse Treatmentfor Women.
Supra note 30.
39 Ibid Winick and Eveans, Supra note 37, found that age of onset of drug use, age entering program, level of
education and years of primary drug use were positively correlated with length of stay (156) with age entering the
program being the most important overall factor - “The older the woman, the more likely she is to achieve longer
retention. This finding is consistent with the maturing-out hypothesis, which proposes that age is very highly correlated
with cessation of drug use” (158). “Age at onset is positivelyrelated to length of stay. The older the woman at the time
of beginning use of the primary drug, the greater the likelihood of success” (1 58).

Appropriateness of the KEY /CREST Program April 2002 Final Report
40 McCorkel, J., Harrison, L., and Inciardi, J. (1997). THE CONSTRUCTION OF TREATMENT AMONG
GRADUATESAND DROPOUTS IN A PRISON THERAPEUTIC COMMUNITY FOR YOMEN, Presented at the
92ndAnnual Meeting of the American Sociological Association Annual Meeting, Toronto, Canada, August.
41 Ramsey, M. (1980). Special Features and Treatment Needs of Female Drug Oflender, M a note 162. See
also, M a note 154 and accompanyingtext. “Drug and alcohol abuse treatment programs are fewer and are not tailored
to the specific needs of women. They have greater medically-relatedproblems, a greater mental health problem, lack of
vocational skills and child rearing problems.” Yang, S. (1990). The Unique Treatment Needs of Female Substance
Abusers in Correctional Institutions: The Obligation of the Criminal Justice System to Provide Parity of Services.
MEDICINE AND LAW 9: 1018 - 1027,1018.
42 Stevens, A and Glider, P. (1 994). Therapeutic Communities: Substance Abuse Treatmentfor Women,
Supra note 30 at 177.
43 Bo&& 3. and Taxman, F. (2000). Client Gender and the Implementation of Jail-Based Therapeutic
CommunityPrograms. JOURNAL OF DRUG ISSUES 30 (4): 88 1 - 900,882. See also, Brown, V., Sanchez, S.,
Zweben, J., and Aly, T. (1996). Challenges in Movingfiom a Traditional Therapeutic Community to a Women and
Children’s TC Model. JOURNALOF PSYCHOACTIVE DRUGS 28( 1) Jan-March: 39 - 46.
“Overt barriers to treatment entry are typicallya fimction of pregnancy, motherhood, or both fbctors.” Coletti,
S., Schinka, J., Hughes, P., Hamilton, N., Renard, C., Sicilian, D., and Neri, R. (1997). Specialized Therapeutic
Community Treatmentfor ChemicallyDependent Women and Their Children (1 15 - 128,117) in DeLeon, G. (Ed.)
COMMUNITY AS METHOD THERAPEUTICCOMMUNITIES FOR SPECIAL POPULATIONS AND SPECIAL
SETTINGS. Greenwood Press: Westport, Connecticut. See also Inpa note 54.
Delaware Health and Social Services, Division of Alcoholism, drug Abuse and Mental Health (1998),
WOMEN-FOCUSED TREATMENT GUIDELINES & BEST PRACTICES at 1 (citations omitted) bereafter cited as
DHSS Report].
Lockwood, D., McCorkel, J., and Inciardi, J. (1 998). Developing Comprehensive Prkon-Based
45
Therapeutic Community Treatmentfor Women, Supra note 14.
46 %id. See also, Stevens, A and Glider, P. (1994). Therapeutic Communities: Substance Abuse Treatmentfor
Women, Supra note 30.
47 DHSS Report, Supra note 44 at 6.
48 DeLeon, G. and Jainchill, N. (1991). Residential Therapeutic Communitiesfor Female Substance Abusers,
BULLETIN NEW YORKACADEMY OF MEDICINE 67(3) May- June: 277 - 290.
49 Ibid. at 28 1. Research has shown that the issue of suicide is linked to the experience that women have. “The
majority of women at Amity‘s Center for Women and Children have experienced assault. At treatment entry 80 percent
of the mothers with children, 68 percent of the pregnant and newly postpartum women, and over 73 percent of the
women without children reported having been assaulted at some time in their life. Furthermore, at treatment entry 6 1.1
percent of the mothers with children, 58 percent of the pregnant and newly postpartum women, and 73.9 percent of the
mothers without children reported having been raped at some time in their life. Many women reported being both
Process Evaluation Assessing the Gender Grant Number 99 - RT - V X - KO16
0 assaulted and raped on numerous occasions. Given the extensive drug history, involvement with the criminaljustice
system, and number of assaults and rapes reported by the women, it is not surprising that many of the women reported
having attempted suicide. For all three groups of women approximately 42 percent reported having attempted suicide.”
Stevens, S., Arbiter, N., and McGrath, R (1997). Women and Children: Therapeutic Community Substance Abuse
-
Treatment (129 141,135-136) inDeLeon, G. (Ed.) COMMUNITY AS METHOD: THERAPEUTIC
Connecticut.
Blume, S. (1990). Chemical Dependency in Women:Important Issues, AMERICAN JOURNAL OF

50
DRUG ALCOHOL ABUSE 16(3&4):297 - 307 at 299.
51 Wilsnack, S., Wilsnack, R., and Hiller-Sturmhofel, S. (1994). How Women Drink: Epidemiology of
Women ’s Drinking and Problems Drinking, ALCOHOL HEALTH & RESEARCH WORLD: THE JOURNAL OF
THE NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM 18(3): (1 73 - 18 1 at 173 - 174).
52 Farrell, A. (2000). Women, Crime and Drugs: Testing the Efect of Therapeutic Communities. WOMEN
AND CRIMINALJUSTICE 11( 1): 2 1 - 48 at 23.
Reed, B. (1987). Developing Women-SensitiveDrug Dependence Treatment Services: m y So Di@cult,

53
JOURNAL OF PSYCHOACTIVE DRUGS 19(2): (151 - 164, at 152).
.
54 “[Tlhe lack of child care is a barrier to treatment but particularly to long-term residential programs . .
compared to men, drug dependent women are more likely to volunteer for treatment and are often more motivated by
concern for their families. But this very concern for their families interferes with their ability to l l l y participate in
treatment. [Clhildren are more likely to become important to addicted women as they progress in treatment. Thus,many
women drop out at an early stage of extended care programs due to guilt about not meeting their children’s needs.”
DeLeon, G. and Jainchill,N. (1991). Residential Therapeutic Communitiesfor Female Substance Abusers Supra note
-
46 at 283 284. See also Supra note 43.
55 Turner, T.H., and Tofler, D. (1 986). Indicators of Psychiatric Disorder Among Women Admitted to Prison.
BRTTISH MEDICAL JOURNAL 298(march 8”): 65 1 - 653, Teplin, L., Abram, IC,and McClelland, G. (1996).
Prevalence of Psychiatric Disorders Among Incarcerated Women:Part I Pretrial Jail Detainees. ACHlEVES
GENERAL PSYCHIATRY 53 (June): 505 - 512, and Jordan, R, Schlenger, W., Fairbank, J., and Caddell, J. (1996).
Prevalence of Psychiatric Disorders Among Incarcerated Women:Part 11 Convicted Felons Entering Prison.
ACHlEVES GENERALPSYCHIATRY 53 (June): 513 - 519.
56 DeLeon, G. and Jainchill, N. (1 991). Residential Therapeutic Communitiesfor Female Substance Abusers
Supra note 48 at 28 1.
57 Reed, B. (1987). Developing Women-Sensitive Drug Dependence Treatment Services: why So Dficult,
58 Ramsey, M. (1980). Special features and treatment needs for female drug offenders, M a note 162 and
Reed, (1987). Developing Women-Sensitive Drug Dependence Treatment Services: Why So Difzcult Supra note 53.
One of the differences between male and female addiction is that addiction itself id defined on white males as

the model and behaviors not within this model are considered variations to the standard. As Reed points out “one
consequence of the male definition for drug dependence is that drug dependent women experience double deviance:
They are not properly female ifthey drink, use unacceptable drugs or engage in unladylike bkhaviors while they are
intoxicated or high. In addition,they are not properly alcoholic or addicted, because their behaviors and psychological
proses do not fit the masculine patterns that are called alcoholism or addiction.” Reed, B. (1987). Developing Women-
Sensitive Drug Dependence TreatmentServices: Why So Dz3mlt Supra note 53 at 153.
59 DeLeon, G. and Jainchill, N., (1991). Residential Therapeutic Communitiesfor Female Substance Abusers
-
Supra note 48 at 281 282.
Ibid at 282.
l
Reed, B. (1 987).Developing Women-SensitiveDrug Dependence Treatment Services: Why So Dtflcult

62 DHSS Report, Supra note 44 at 7-8.
63 zankowski, G. (1987).Responsive Programming: Meeting the Needs of Chemically Dependent Women.

ALCOHOLISM TREATMENT QUARTERLY 4(4): 53-66.
64 Lockwood,D., Inciardi, J., and Surratt, H. (1997). CREST Outreach Center: A Modelfor Blending
-
Treatment and Corrections (70 82), in Tims, F., et. al., (Eds) THE EFFECTIVENESSOF INNOVATIVE
APPROACHES IN THE TREATMENT OF DRUG ABUSE. Greenwood Press: Connecticut. See also, Inciardi, J.,
Martin, S., Lockwood,D., Hooper, R. and Wdd, B. (1992). Obstacles to the implementationand evaluation of drug
treatmentprograms in correctional settings: Reviewing the Delaware KEY experience (1 76-19I), in Leukefeld, C. and
Tims, F. (E&), DRUG ABUSE AND TREATME” IN PRISONS AND JAILS. National Institute on Drug Abuse:
Rockville, MD.
65
Lockwood, D., Inciardi, J., and Surratt, H. (1 997). CREST Outreach Center:A Modelfor Blending
Treatment and Corrections,Supra note 49,Lockwood, D. and Inciardi, J. (1 993). CREST Outreach Center: A Work
Release Iteration of the TC Model (61-69),in Inciardi, J., T h ,F., and Fletcher, B. (Eds.) INNOVATIVE
APPROACHES IN THE TREATMENT OF DRUG ABUSE. Greenwood Press: Connecticut, and Inciardi, J. and
Lockwood,D. (1994). m e n Worlds Collide: Establishing CREST Outreach Center (63-78),in Fletcher, B.,Inciardi, J.
and Horton, A. (Rds.) DRUG ABUSE TREATMENT: THE lMpLEMENTATION OF INNOVATIVE
APPROACHES. Greenwood Press: Connecticut.
66
Lockwood, D. (1 992). MODELING A MODIFIED TC DESIGN FOR WORK RELEASE. Presented at the
Annual meeting of the Academy of Criminal Justice Sciences. Pittsburgh, PA, March 10-14, Lockwood,D. and
Inciardi, J. (1 993). CREST Outreach Center: A Work Release Iteration of the TC Model, Supra note 50 and Inciardi, J.
and Lockwood,D. (1994). When Worlds Collide: Establishing CREST Outreach Center, Supra note 65.
68
Lockwood, D. and Inciardi, J.( 1993).CREST Outreach Center: A Work Release Iteration of the TC Model,
Process Evaluation Assessing the Gender Grant Number 99 - RT VX - KO16 -
Page 63 of 70
I
69 See, Lockwood,D. and Inciardi, J.(1993).CREST Outreach Center: A WorkRelease Iteration of the TC
Model, Supra note 64 and Inciardi, J. and Lockwood, D. (1 994). when Worlds Collide: Establishing CREST Outreach
Center, 50 for detailed discussion on design and implementation of CREST.
’ Lockwood,D., McCorkel, J., and Inciardi, J. (1998).Developing ComprehensivePrison-Based

O
Therapeutic Community Treatmentfor Women,Supra note 14.
7’ Inciardi, J. and Lockwood, D. (1994). when Worlds Collide: Establishing CREST Outreach Center, Supra
i
note 65.
72 Ibid. at 66.
73 Farrell, A. (2000). Women, Crime and Drugs: Testing the Effect of Therapeutic Communities, Supra note
42,Lockwood,D., Inciardi, J. Butzin, C., and Hooper, R (1997). The Therapeutic Community Continuum in
Corrections, Supra note 9,Lockwood,D., Inciardi, J., and Surratt, H. (1 997). CREST Outreach Center: A Modelfor
Blending Treatmentand Corrections,Supra note 49 ,Neilsen, A., Sacpitti, F., and Inciardi, J. (1996).Integrating the
Therapeutic Community and WorkReleasefor Drug-Involved Offenders: The CREST Program. JOURNAL OF
SUBSTANCEABUSE TREATMENT 13(4): 349 - 358,Butzjn, C.,Martin, S. and Inciardi, J. (1996). IMPACT OF A
THERAPEUTICCOMMUNITY WORK RELEASE PROGRAM AND EMPLOYMENT STATUS ON THE
RELAPSE OF DRUG INVOLVED OFFENDERS. Presented at the 1996 Annual Meeting of the American Societyof
Criminology,Chicago, Illinois November 21 ,Inciardi, J. and Lockwood, D. ( 1994). when Worlds Collide: Establishing
0 CREST Outreach Center, Supra note 65,Lockwood, D. and Inciardi, J.( 1993). CREST Outreach Center: A Work
Release Iteration of the TC Model, Supra note 65.
74 Neilsen, A., Scarpitti, F., and Inciardi, J. (1996).Integrating the Therapeutic Community and Work Release
for Drug-Involved Offenders: The CRESTProgram, Supra note 73.
75
Ibid. at 356.
76 Ibid. at 355.
77
Ibid at 356.
79
Inciardi, J. Butzin, C., and Hooper, R. (1 997). The Therapeutic Community Continuum in Corrections,
Supra note 9.
80
Ibid. at 95.
Neilsen, A., Sacpitti, F., and Inciardi, J. (1996). Integrating the Therapeutic Community and Work Release
Report to the National Institute of Justice Delaware Crimiial Justice Council

Page 64 of 70
for Drug-Involved Offenders: The CREST Program, Supra note 73.
82 Lockwood,D., Inciardi, J., and Surratt,H. (1997). CREST Outreach Center: A Modelfor Blending
Treatment and Corrections, Supra note 64.
83
Ibid. at 77.
84
Ibid.
85 Ibid.
86 Neilsen, A., Scarpitti, F., and Inciardi, J. (1996). Integrating the Therapeutic Communiv and Work
Releasefor Drug-Involved Offenders: The CRESTProgram, Supra note 73 at 354 355. -
87
Ibid.
Lockwood, D., Inciardi, J., and Surratt, H. (1 997). CREST Outreach Center: A Modelfor Blending
88
Treatment and Corrections,Supra note 64 at 77.
89 Farrell, A. (2000). Women, Crime and Drugs: Testing the Eflect of Therapeutic Communities, Supra note
52.
9Q Ibid at 36.
91 Ibid. at 37.
92 Lockwood,D., Inciardi, J., and Surratt, H. (1997). CREST Outreach Center: A Modelfor Blending
Treatment and Corrections,Supra note 64 at 77.
93 Farrell, A. (2000). Women, Crime and Drugs: Testing the Effect of Therapeutic Communities, Supra note
52 at 36.
94
Ibid. at 38.
95 Connection with fiiends and relations was not found to be significant at .OS, while treatment and treatment
fiequency was found significant at .05. Ibid.
% Ibid. at 39.
97
Ibid at 44.
98
Lockwood,D., McCorkel, J., and Inciardi, J. (1 998). Developing ComprehensivePrzkon-Based
Page 65 of 70
Therapeutic Community Treatmentfor Women,Supra note 14.
McCorkel, J., Hamison, L., and Inciardi, J. (1998). How Treatment in ConstructedAmong Graduates and
99
Dropouts in a Prkon Therapeutic Communityfor Women, Supra note 34.
loo See, McCorkel, J., Harrison,L., Inciardi, J. Lbckwood, D., Hooper, R., Scarpitti, F., Martin, S., Wald, B.,
Butzin, C., Pan, H., Nielsen, A. in Supranotes 3,9, 10, 14, 19,20,33,34,35,40,64,65,66,73.
See also, Martin, S. and Inciardi, H. (1997). Case management Outcomesfor Drug-Involved Oflenders, THE
PRISON JOURNAL 77(2): 168 - 183; Martin, S., Butzin, C., Saum, C., Inciardi, J. (1999). Three Year Outcomes of
Therapeutic Community Treatmentfor Drug-Involved Oflenders in Delaware: From Prison to Work Release to
-
A3ercare. THE PRISON JOURNAL 79(3): 294 320; Scarpitti, F., Inciardi, J., Pottieger, A. (1 993). Process
Evaluation Techniquesfor Corrections-basedDrug Treatment Programs, JOURNAL OF OFFENDER
REHABILITATION 19(3/4): 7 1 - 79; Inciardi, J., Lockwood, D., and Hooper, R. (1 994) Delaware Treatment Program
-
Presents Promising Results. CORRECTIONS TODAY February: 34 42; B b , C., Scarpitti, F., Neilsen, A., Martin,
S., and Inciardi, J. (1 999). Measuring the Impact of Drug Treatment: Beyond Relapse and Recidivism.
CORRECTIONS MANAGEMENT QUARTERLY 394): 1 - 7; and Martin, S., Lockwood, D., Inciardi, J., and
Freeman, C. (1992). PREDICTING RELAPSE AND RECIDIVISM AMONG RELEASED DRUG USING
INMATES: THE EFFICACY OF TREATMENTALTERNATIVES, Presented at the Annual Meeting of the American
SociologicalAssociation, Pittsburgh, Pa. August 20, 1992.
lo’ Rose, A. (2000). 1999 DISCHARGED POPULATION OF THE KEY V U G E DRUG TREATMENT
PROGRAM: BAYLOR WOMEN’S CORRECTIONALINSTITUTE PRELIMINARY DATA ANALYSIS. -
Delaware Criminal Justice Council: Wilrnington, De. (See appendix one).
102
Ibid. at 2.
lo3 aid. at 3.
104
Ibid. at 6.
lo5 Supra notes 41 - 42,48 - 49 and accompanyingtext.

lo6 Rose, A. (2000). 1999 DISCHARGED POPULATION OF THE KEY VILLAGE DRUG TREATMENT
PROGRAM: BAYLOR WOMEN’S CORRECTIONALINSTITUTE PRELIMINARY DATA ANALYSIS, Supra-
note 101 at 7.
lo7Due to data entry error, the data in the report by Rose on page 7 in regard to types of abuse is incorrect. The
correct statistics are reported in this report.
lo* Supra notes 55 - 56 and accompanyingtext.
log Rose, A. (2000). 1999 DISCHARGED POPULATION OF THE KEY VILLAGE DRUG TREATMENT
Report to tbe National Institute of Justice Delaware Criminal Justice Council
Implemented at the Beylor Women’s Correctional Institute
Page 66 of 70
Supra notes 49’55 and accompanyingtext.
l1 Rose, A. (2000). 1999 DISCHARGED POPULATION OF THE KEY VILLAGE DRUG TREATMENT
PROGRAM: BAYLOR WOMEN’S CORRECTIONAL INSTITUTE - PRELIMINARY DATA ANALYSIS, Supra
note 101 at 10.
112
hid
i
‘I4 Ibid at 11.
115 %id. at 12.
116
Ibid.
Ibid. at 13.
Ibid. at 15.
11’ %id
I2O Haslett, B. (2001). EVALUATION OF THE GENDER APPROPRIATENESS OF THE FEMALE

OFFENDER’S SUBSTANCE ABUSE PROGRAM. Delaware Criminal Justice Council: Wilmington, De. (See
Appendix Two).
12’ For discussion ofthese differences see research noted in Supra notes 3,9,10,14,19,20,48 and 65.
122 See Supra notes 48 and 65.
123Haslett, B. (2001). EVALUATION OF THE GENDER APPROPRIATENESS OF THE FEMALE

OFFENDER’S SUBSTANCE ABUSE PROGRAM, Supra note 120 at 3.
125
Ibid

Implemented at the Baylor Women’s Correctional Institute Page67of 70
128
Ibid.
129 Ibid. at 6.
130 %id.
131
Ibid. at 9 (emphasis added).
132DeLong, G. (1997). Therapeutic Communities: Is There an Essential Model? Supra note 4 at 9.
133 DHSS Report, Supra note 44 at 6.
134 Haslett, B. EVALUATION OF THE GENDER APPROPRLATENESS OF THE FEMALE OFFENDER’S

SUBSTANCE ABUSE PROGRAM, Supra note 120 at 6
135 “The lack of aggressive social conditioning in women directlyrelates to the inadvisability of using
aggressive, cor&ontational techniques of the encounter group with them. The encounter group is the mainstay of
traditional therapeutic community treatment techniques. While men respond to this approach, women will not, for they
have been conditioned to believe that they are inferior and should not be assertive. Women are trained to be submissive,
’
.
conforming, and dependent. None of these attributes appears in the social conditioning of men. .. The ramifications of
0 this system have been an asset to drug treatment p r o g r d g for men,but not for women. Basically, men are more
able to separate their drug use of drugs fkom their other social roles which carry experiences of success. The total being
of a man is not destroyed by his use of drugs; he is still a man. In contrast, when a woman is identified and stigmatized
.
as a drug user, every aspect of her being is questioned and ridiculed. . . Consequently, in treatment p r o g r d g ,
female drug offenders will enter therapy with much greater sense of alienation and disorientation than their male
counterparts.” Ramsey, M. (1 980). Speck1features and treatment needs for female drug oflenders. M a note 162 at
3 57-3 58.
Haslett, B. EVALUATION OF THE GENDER APPROPRIATENESS OF THE FEMALE OFFENDER’S

SUBSTANCEABUSE PROGRAM, Supra note 105 at 7.
138 Ibid
139
Ibid.
140
Ibid. at 8.
141
%id. (Emphasis added).

P r m Evaluation Assessing the Gender -
Page 68 of 70
142
Ibid at 10.
143 B i d
144 Ibid -
at 12 13.
145 Ibid. at 13.
'41 Ibid.
147Correspondence with author after review ofpreliminary draft.
'41 The term "famiiy" and women are used interchangeably.
149 DeLong, G. (1 997). l"herapeutic Communities: Is mere an Essential Model? Supra note 4 at 1 1.
150 The CREST Outreach Center (1994). THE CREST CLIENT ORIENTATION MANUAL.
Correctional Medical Services (1 994). THE KEY PROGRAM ORENTATION MANUAL
152 Ibid See also, Supra note 17 and accompanyhg text.
153 Correctional Medical Services (1 994). THE KEY PROGRAM ORIENTATION MANUAL, Supra note
151 at 6.
154 Bouffard, J. and Taxman, F. (2000). Client Gender and the Implementation of Jail-Based Therapeutic
CommunityPrograms, Supra note 43 at 885 - 886.
155 The CREST Outreach Center (1 994). THE CREST CLIENT PRIENTATION MANUAL, Supra note 15 1
at 8.
15' A familymember at CREST.
157
Ibid.
158
See Supra notes 42 - 43,48 - 60 and accompanyingtext.
159 Henderson, D., Schaeffer, J. and Brown, L. (1998). Gender-Appropriate Mental Health Services for
Incarcerated Women:Issues and Challenges, Supra note 2 at 46.
160
Reed, B. (1987). Developing Women-SensitiveDrug Dependence Treatment Services: w h y So Dlficult
Report to the National Institute of Justice Delaware Criminal Justice Count3
e 16’ See Supra notes 136 - 141 and accompanyingtext.
162 BoufEid, Jand Taxman, F. (2000). Client Gender and the Implementation of Jail-Based Therapeutic
Community Programs, Supra note 43 at 884. See also, h e y , M. (1980). Specialfeatures and treatment needsfor
female drug offenders. JOURNAL OF OFFENDER COUNSELING, SERVICES, AND REHABILITATION, 4 (4):
357 - 368 and Peugh, J. and Belenko, S. (1999). Substance-involved women inmates: Challenges to providing
eflective treatment. THE PRISON JOURNAL 79 (1): 23 - 44.
163 Stevens, S., Arbiter, N., and Glider, P. (1989). Women Residents: Expanding Their Role to Increase
TreatmentEffectiveness in Substance Abuse Programs. THE INTERNATIONAL JOURNAL OF THE ADDICTIONS
24 ( 5 ) : 425 - 435,433.
164 See Supra notes 40,45 - 46 and accompanyingtext.
165 Henderson, D., Schaeffer, J. and Brown, L (1 998). Gender-AppropriateMental Health Servicesfor
Incarcerated Women:Issues and Challenges, Supra note 2 at 46.
16‘ Reed, B. (1985). Drug Misuse and Dependency in Women: The Meaning and Implications of being
Considered a Special Population or Minority Group. THE INTERNATIONAL JOURNAL OF THE ADDICTIONS
-
20(1) 13 62, at 50.
16’ “[Cllient constructions of ‘treatment’ are a central conceptual device through which experiencesin
treatment are rendered meanin@ and evaluated. Further, such constructions often serve as a basis on which decisions
to prematurelyleave the program are made.” McCorkel, J., Harrison, L., and Inciardi, 3. (1998). Supra note 34 at 39.
“The TC is behaviorally oriented but the process of change is primarily understood by the participants themselves in
subjectiveterms, through perception and experiences.” DeLong, G. (1997), Therapeutic Communities:Is There an
Essential Model? Supra note 4 at 11.

1999 DISCHARGED POPULATION OF THE KEY VILLAGE
e DRUG TREATMENT PROGRAM
BAYLOR WOMEN’S CORRECTIONAL INSTITUTE
. Preliminary Data Analysis
Data Analysis by -
Arthur Garrison
Alison E. Rose
Written by
Alison E. Rose
August 17,2000
I
1999 DISCHARGED POPULATION OF THE KEY VILLAGE

DRUG TREATMENT PROGRAM
Preliminarv Data Anaivsis
General demographical statistics
Information was obtained fiom files of the 105 women discharged in 1999 from
the Key Village drug treatment program located at Baylor Women's Correctional
Institute. The current research evaluation is attempting to determine whether the Key
Viuage is gender appropriate because this treatment philosophy was transferred fiorn-a
drug treatment program in a men's prison. Current participants in the Key Village will be
interviewed regarding their perceptions of the gender appropriateness of the treatment
program. The interview questions will be coni$ructed based upon the data analyzed &om
the women discharged in 1999.
The following information descnis the general demographical statistics of the
participants discharged f?om the Key Village program in 1999. The first area observed is
race. The concept of race/ethnicity was broken down into five different categories.
These include Caucasian, Mican-American, Asian/Pacific Islander, Hispanic, and other.'
The breakdown of these categories is displayed in Table I.
Table I. RaceEthnicity of Key Village Participants Discharged in 1999.
Racemthn icity Frequency Percentage

Caucasian N=55
- __ 52.4%
..-
African-American N=45 42.9%
AsianRacific Islander N=l 1.0%
Hispanic N=4 3.8%
Other N=O 0.0%
Total N = 105 100.0%
2
As Table I Uustrates, the participants of the Key Village in 1999 were comprised
mostly of Caucasian (52.4%) and African-American (42.9%) women.
The second area observed was marital status. The categories for marital status
were broken down into single, married, divorced, and separated. Table 11 portrays the
categorization for the variable of marital status.
Table 11. Marital Status of Key Village Participants Discharged in 1999.
As depicted in Table 11, the majority of women were' single (60.6%) with the
second highest percentage being divorced women (20.2%). The combined percentages of
unmarried women (88.5%) are substantial enough to consider an interview question
based upon the support network of significant others as being integral in successhlly
-
completing the Key Village treatment program.
The third demographical area observed was the highest level of educational
achievement obtained by the women prior to entering the Key Village treatment program.
The categories for education were classified as completing less than a 9" grade
education, 9* grade, 1O* grade, 11th grade, 12'h grade, 12" grade with additional
vocatiodtechnical training, 12" grade with additional college courses, or obtaining a
Bachelor's degree. The breakdown of these categories follows in Table III.
** *
'3
Table 111. Highest Level of Educational Achievement Obtained by Key Village

Participants Discharged in 1999.
As Table I11 illustrates, unfortunately the largest portion of the women (57.1%)
obtained less than a 12* grade education prior to being incarcerated. Interestingly, very
similar percentages of the women had a gh grade education or less (16.2%) compared to
a those who obtained higher than a 12* grade education (15.3%).
The fourth area observed was the length of the longest job held by the
participants. Perhaps the longer an individual is able to stick with a job, the longer they
will be able to persevere with their drug treatment program. Table IV displays the
categories of length of longest job held. These categories include jobs held from one to
twelve months, 13 to 36 months, 37 to 60 months, 61 to 84 months, 85 to 108 months, or
109 months or longer.
4
Table IV. Length of Longest Job Held by Key Village Participants Discharged in
1999.
I 85-108 Months
109 or More Months
'Total
-
N=5
N=8
4.8%
7.7% 1
As displayed in Table IV, 36.5% of the participants were not able to hold the
same job for longer than one year. Over seventy percent were not able to maintain the
same job for longer than three years.
The fifth area observed was age. The concept of age was broken down into seven
different categories. The first category included women in the age range of 18 to 20
years old; the second was 21 to 25 years old; the third was 26 to 30 years old; the fourth
was 3 1 to 35 years old; the f%h was 36 to 40 years old; the sixth was 41 to 45 years old;
and the seventh was 46 to 50 years old. Table V portrays the categories based on age.
-
5
Table V. Age of Key Village Participants Discharged in 1999.
i
I
As displayed in Table V, the largest age group category (25.7%) was comprised
of women between the ages of 26 and 30. W e almost twenty-five percent of the
women were 25 years old or younger, interestingly, over thirty percent of the women
were over the age of 35. Perhaps the larger representation of more mature women is a
factor that needs to be considered when creating survey items and interview questions.
The presence of children could be an influential fbctor in a client's progress in a
treatment program. Table VI details the number of children, if any, the women had prior
-
to entering the Key Village program.
Table VI. Number of Children the Discharged Participants From the Key Village in
1999 Had Prior to Entering the Key Village Treatment Program.
As depicted in Table VI, the majority of the women responding to this question
'
(80.6%) were mothers. Of those women who have children, 62.3% had three or fewer
...
6
children when they entered the Key Village program. For interview and survey purposes,
Table VII crosstabulatesthe number of children with the eequency of discharge status, or
e
the successfuUunsuccessh1 discharges fkom the Key Village in 1999. The category
“Other” represents women who were discharged for medical reasons, or whose sentence
ended while they were participating in the Key Village program.

/
Table VII. Number of Children Compared with Discharge Status of the
I
Participants Discharged from tbe Key Village in 1999.
Table VII displays successful versus unsuccessfU1 discharges compared with the a
number of children the women discharged in 1999 had. A chi-square test was run to
determine whether there was a statistically significant difference in the number of
children the women had compared with their discharge status. No statistically significant
difference was found at the .05 level. However, it .is interesting to note that of the 76
responding women, those with children were all more successfulthan not.
Background history
Research has shown that a majority of incarcerated women have suffered some
history of abuse during their lifetime. Table VI11 depicts whether or not the participants
discharged fiom the Key Village in 1999 experienced some type of’ abuse. Their
responses are categorized into yes or no answers.
7
Table VIII. Abuse History of Participants Discharged From the Key Village
Program in 1999.
As portrayed in Table VIII, 78 women answered the question regarding their

history of experiencing abuse, providing a response rate of 74.3%. Of those responding
women, an overwhelming majority (92.3%) experienced some form of abuse d u h g their
lifetime. Unfortunately, this is quite a substantial statistic. For interview purposes, this is
certainly an area that could be delved into when considering the drug and/or alcohol
use/abuse history of the Key ViUage participants being studied.
For W h e r clarification of abuse history, Table JX breaks abuse down by specific
types. The categories include physical abuse, emotional abuse, sexual abuse, or
combinations thereof.
Table IX. Specific Type of Abuse Experienced by Participants Discharged from the
Key Village Program in 1999.-
Type of Abuse Frequency Percentage

Physical N=l 1.4%
Sexual N=2 ~ 2.7%
- - . I -
Emotional N = 12 16.2%
EmotionaVSexual N = 12 16-2%
EmotionaVPbysicaYSex:uaI ,I .. N = 28 37.8%
ErnotionaVPhysical N = 15 20.3% ~~
I PhvsicaVSexual I N=2 I 2.7%

None . N=2 2.7%
Total N = 74 100.0%
,.
>
:.
;
'
8
As depicted in Table IX, the highest categorical percentage (37.8%) is represented
by those women who experienced a combination of emotional, physical, and sexual
abuse.
The next area observed was the history of psychiatric treatment. Table X displays
the yes or no answers from the Key Village participants regarding previous treatment for
emotional and/or psychological daculties.
Table X. Psychiatric History of Key Village Participants Discharged in 1999.
As displayed in Table IX, a 98.1% response rate was recorded to the item
regarding previous psychiatric history with 63.2% of those respondents claiming no prior
psychiatric treatment. Research has shown that history of abuse can cause emotional
and/or psychological distress that may not present itselfimmediately, but manifest itself -
later in Me. Therefore, when considering the number of Key Village participants who
suffered fiom abuse, it seem many women needed treatment and did not receive it.
Although a majority of the Key Village participants responded that they did not
have a psychiatric history, many reported having symptom that could possibly need
psychiatric intervention Table XI displays the Key Village participant's yes or no
responses to items concerning their history with bouts of deep depression, serious
anxiety, and trouble concentrating or comprehending.
9
Table XI. History of Depression, Anxiety, and Troubie Comprehending
1 1 I 1;
Experienced by Key Village Participants Discharged in 1999.
N=57 72.2%
Experience Depression N=79
Experience
AnxietyRensionlNervousness
I 1; 1 :f 1
,
N = 22
N=54
N=23
I
27.8%
70.1%
29.9%
I
I
N = 77
1 1 I
I I
Experience Trouble
Comprehending,
N=77
Concentrating, or
Remembering
~
Of those Key Village participants responding to the items depicted in Table XI,
72.2% experienced deep depression at some time in their lives. Also, 70.1% of the
-
women had experienced serious anxiety, tension, and/or nervousness. Finally, over sixty-
three .percent experienced trouble comprehending, concentrating, or remembering during
their Ilfetime. A minority of women also listed histories of hallucinations, paranoia,
violent behavior, and suicidal thoughts andor attempts.
Research has shown that many individuals must undergo multiple drug and/or
alcohol treatments before they are able to manage their addiction. Table XI1 portrays the
Key Village participant’s yes or no answers in regard to history of prior drug and/or
alcohol treatment.
10
Table XII. Prior Drug and/or Alcohol Treatment History of Key Village
Participants Discharged in 1999.
~
Prior Drug and/or Alcohol TX Frequency Percentage

Yes N = 79 I
77.5%
. ..-_-
L No N = 23 22.5%
Total N = 102
As illustrated in Table XI, a sizeable majority (77.5%) reported previous drug
and/or alcohol treatment prior to entering the Key Village program. This prior treatment
could have been anything fiom a detoxification program to a lengthy drug or alcohol
treatment program.
Table XI11 clarifies the issue of prior drug andor alcohol treatment of Key
Village participants by grouping the number of prior treatments they have received into:
(a) having no prior treatments, (b) one to five prior treatments, (c) six to ten prior
treatments, or (d) eleven or more treatments.
Table XIII. Number of Prior Drug and/or Alcohol Treatments Received by Key
Village participants Discharged in 1999. -
I Number of Prior Treatments 1 Frea uencv Percentage
As shown in Table XIII, the majority of women (55.0%) had one to five prior
drug and/or alcohol treatments upon entering the Key Village program.
Successhl or unsuccessfid completion of a drug andor alcohol treatment program
does not automatically Iead to the suspension of using drugs. Table XI11 displays the
11
results &om the last drug and/or alcohol treatment program the Key Village participants
a discharged in 1999 attended prior to entering the Key Village program. I
Table XIV. Outcome in Last Alcohol and/or Drug Treatment Program Attended by
the Key Village Participants Discharged in 1999.
As depicted in Table X I V , 56.3% of the Key Village participants discharged in
1999 were successful in their last treatment program, yet were not able to abstain f3om
using drugs.
When studying an individual’s drug abuse history, the age of first drug use is an
important component. Table XV sorts the age of first drug use into five different
categories. The first category is 15 ye& old or younger, the second is 16 years old to 20
years old, the third is 21 years old to 29 years old, the fourth is 30 years old to 39 years
old, and the finaI category is 40 years old or older.
Table XV. Age of First Drug Use by Key Village Participants Discharged in 1999.
Age of First Drug Use Frequency Percentage

15 Years Old or Younger N=56 54.4%
Sadly, Table ,XV displays that over fifty-four percent of the Key Village
participants started using drugs before they were 16 years old.
12
In order to gain further insight into the population under evaluation, it is useful to
explore the type of drug(s) used most often by the participants discharged from the Key
Village program in 1999. Table XVI displays the drug(s) of choice in five different
categories. These include: heroin, cocaine/crack, cannabis, hallucinogens, or using
cocaine andor heroin while also using a separate drug of choice.
Table XVI. Drug(s) of Choice ofKey Village Participants Discharged in 1999.

~ ~
Heroin
Cocain e/Crack
N=3
N = 15
I 2.9%
14.6% I
As displayed in Table XVI, a substantial majority (79.6%) preferred a
combination of drugs including cocaine and/or heroin.
It is interesting
- to note how the Key Village participants discharged in 1999
supported their addictions. Table XVII displays the means of supporting addiction in two
variables. These include legal and illegal means. Legal means are defined as money
donated by fiends and f d y , work, welfare checks and disability checks. Prostitution,
shoplifting, fiaud, selling drugs, and robbery define illegal means.
13
Table XVII. Means of Supporting Addiction Used by Key Village Participants

Discharged in 1999.
I
I
As displayed in Table XVII, an overwhelming majority (74.0%) used illegal
meam to support their drug abuse.
Discharge infoxmation
Table XVIII displays the discharge status of the Key Village participants
discharged h 1999. The categories are successfid, unsuccessfid, or other. A successfid
discharge is defined as one where the participant completes the orientation and primary
treatment phase of the Key Village program and is transferred to another facility to
e participate in the next phase of their treatinent plan. This might be a work-release
program, home-codinement, or an aftercare program. An unsuccessii~l

- discharge is
defined as one where the participant fails to complete either the orientation or primary
phase of tlie Key Village program. The category of "other" is designated for those
participants who left the Key Village program voluntarily, because of medical reasons, or
because their sentence ended while they were still involved in the Key Village program.
Table XVIII. Discharge Status of the Key Village Participants Discharged in 1999.
~-
I SuccessfuI I
I
N=47 .. ' I
I 45 7?4
.I._,"
Unsuccessful N = 47 45.2%
14
As depicted in Table XVIII, an equal number of Key Village participants were
successfil (45.2%) and unsuccessfil (45.2%) when discharged in 1999. Numerous
variables were crosstabulated with the variable of discharge status and a chi-square test
was run to determine ifthere were any statistically significant differences at the .05 level.
There were no statistically significant chi-square values at the .05 level when the
variables of race, age, religion, previous occupation, level of education, marital status,
length of 'longest job, number of children, prior drug use, age of first drug use, type of
drug used, abuse history, number of prior drug and/or alcohol treatments, medical history,
and prior criminal history were crosstabulated with the variable of discharge status.
Previous psychiatric history was the only variable providing a statistically significant chi-
square value at the .05 level when crosstabulated with discharge status. Table XIX
displays the crosstabulation of previous psychiatric history with discharge status.
Table XIX. Previous Psychiatric History Compared with Discharge Status of the
Key Village Participants Discharged in 1999.
I I Discharee Status *
Total
Su ccessfuI Unsuccessful
-
VPC N = 10 I N = 3n
No N=36 N = 26 N=62
i
I
Total
- I
I
N=46.- I
I
N
- . = 4.-
hp 1
I
N
* , = a3
/ L
I
Category "Other" was removed from Discharge Status for cbi-square analysis.
As determined by a chi-square test, Table XIX displays that significantly more

participants were successfid when they had no prior psychiatric history.
The final area analyzed was the week the participants exited the Key Village
program. Table XX details the number of participants who exited the Key Village
program during.a particular week and which phase of the Key Village they were in when
they exited. The phases include the orientation phase, which generally lasts for the first
15
month. and the prhary treatment phase, which continues until the participant completes
the Key Viliage.
Table XX. Week and Phase Exited by Key Village Participants Discharged in 1999.
* Category "Other" was removed from Discbaqe Status for comparison purposes.
As indicated in Table XX, the weeks with the highest drop out numbers were
weeks one through five-where 27 participants unsuccessfdy exited the Key Village
program. Twenty-five out of those 27 participants were still involved in the Orientation
phase of the Key Village. Logically, it seems that the longer a participant is involved in
the treatment program, the more likely they will be successfid upon completion of the
program. It is important to determine what factors are prevalent during the Orientation
phase which produce such large dropout numbers.
EVALUATION OF THE GENDER APPROPRIATENESS OF THE FEMALE
OFFENDER'S SUBSTANCE ABUSE PROGRAM
/
i
SUBMITTED BY
BETH BONNJWELL HASLETT, PH..D
FOR THE NATIONAL INSTITUTE OF JUSTICE GRANT, 1999 RTVX KO1 6

AWARDED TO THE DELAWARE CRIMINAL JUSTICE COUNCIL
JANUARY 3 1,2001
Executive Summary
This report assesses the gender appropriateness of the TC program for female
substance abuse ognders. The TC programs are designed to help clients recognize and
confront their patterns of substance abuse and criminality. Generally, these programs
have been successfbl in reducing recidivism among substance abuse offenders. However,
these programs were designed for male substance abusers, and given the growing body of
research on gender differences arid the increase in female offenders, it seemed usem to
evaluate whether or not the TC programs were appropriate for female offenders. The
findings in this report are based on over 100 hours of observation and Minterviews at
TC programs throughout Delaware.
These findings are grouped in four broad categories: external factors that
influence the TC programs; physical fkcGtties;the structure and curriculum of the TC
programs; and the TC staff.
External factors. The TC programs run within the context of the DOC and
various correctional institutions. More frequent dialogue between the TC directors and
DOC would help develop more awareness of the TC program, its needs and its
relationship to the correctional institutions. More hnding is needed for women inmates,
0 and for TC programs for women in particular. Community services also need to be
expanded to help the transition of clients back into society. Because many female
offenders have significant histones of abuse, more mental health providers should be
available for inmates (e.g., licensed clinical psychologists, board certified psychiatrists,
etC.)
Physicial facilities. It is critical that separate Crest facilities for women be

established so that a psychologically safe environment can be provided for them.
Although a new facility is being built, steps should be taken immediately to provide
separate, temporary quarters. Existing hcilities need to be modified to provide private
space for client intake and counseling sessions, and a large group area for gathering the
entire TC family.
Structure and functioning of the TC programs. The house structure and

house rules need to be reviewed so that a clear therapeutic benefit can be established for
the hierarchy and job functions. In addition, the TC staffneeds to monitor careMly how
clients cany out these responsibilities and to remove clients who may abuse these
positions of responsibility. The curriculum needs to be updated and the overall
curriculum needs to be sequenced over the Key and Crest phases. Additional materials
for women should include information that is consistent with an introductory course in
the psychology of women, and more information on sexual abuse and domestic violence,
spirituality, health issues for women, and job training. General information on substance
e abuse should be tailored specifically for either a female or male audience.
TC Staff. Generally, the TC staEconsists of dedicated, hardworking individuals
who are genuinely committed to assisting their cIients. And they carry out their tasks in
less-than-optimal conditions, which includes a lack. of space, lack of privacy and
continuous change as a part of their daily work. Staff should be provided with more
training and computers to help them handle the record keeping and client files. More
staff should be hired with training in areas like social work, psychology, and
communication to supplement the skills of the currently employed staff
Gender Appropriateness of the Female Offender Substance Abuse Program
The Delaware Criminal Justice Council received a grant fiom the National
Institute of Justice (NIJ)to review the gender appropriateness of the Therapeutic
Community Substance Abuse Program being used in Delaware’s correctional facilities.
Various therapeutic communities (hereafter referred to as TCs) have been established
throughout prisons in the United States and met with some success in reducing recidivism
and substance abuse. Delaware’s program was initially started in 1988 and used in male
prisons. In 1994, the Key Village program was started at the Baylor Women’s
Correctional Institution and by May, 1999,35 1 women had been admitted to the program
and 114 had successfblly completed it (32%).
The TCs were developed for male prisoners, and in light of the research
establishing significant gender differences, it is appropriate to review the TC program for
e its gender appropriateness for women. Officials and staffworking in correctional

facilities have long noted behavioral and attitudinal differences between female and male
prisoners (hereafter referred to as clients), as well as differences in patterns of substance
abuse. In order to enhance the effectiveness of TC programs, it seems reasonable to
assume some modifications in the traditional TCs may be needed in order to adapt to the
unique needs of female prisoners.
Why should we be concerned about the gender appropriateness of TC programs?

First, given our understanding of significant gender differences, it is usefbl to examine
the TCs’ effectiveness for women, especially since the TC programs were designed for
male prisoners. Ifwe want to decrease substance abuse and crime, it makes sense to
design programs that do this as effectively as possible. Second, the rate of incarceration
of women is growing very rapidly and at a fsster rate than male incarceration, so we need
to address the needs of women directly rather than assuming one model (the male model)
fits all prisoners. Finally, and this is perhaps the most compelling reason, women are
primarily responsible for child rearing and raising the next generation. If we reduce
fbture substance abuse and crime by treatment of female offenders, we intervene in the
generational cycle of substance abuse and crime. Clearly, the success of treatment
programs-not only generally, but especially for women- is in society’s best interest.
The current investigation examines the gender appropriateness of TCs for female
offenders, and makes recommendations as to how the program can be adapted to enhance
its effectiveness for female offenders. I have been observing TC programs at various
a sites throughout Delaware, and interviewed staff about the TCs. I have not interviewed
2
clients directly about the TCs bemuse focus groups and client interviews were conducted
separately as part of this grant. However, I did observe client interactions, caseload
meetings and group encounter sessions, and will include relevant client responses from
those settings.
During my observations, it became clear that program effectiveness was a

function of many factors, some of which were external to the curriculum and practices of
the TCs. In order to gauge the effectiveness of TCs, I looked at a broad range of factors
which influenced the delivery and effectiveness of the program generally, as well as at
the specific curriculum and structure of the TC program. My training in organizational
communication as well as gender issues will enable me to offer this broad perspective.
Throughout my observations, I have been very impressed with the dedication of

both the staff and clients. Clients were very accepting of my presence, and staffat all
facilities graciously answered my questions despite having a very heavy workload and
other demands on their time. I have great respect for the hard work and dedication of
both clients and staff.
In what follows, I will o u t h e observations and recommendations in various

areas, covering general organizational issues as well as specific cunicular suggestions.
I. Relationshim of the TC Droeram with its external environments.
The TC program involves three phases: the Key Village, Crest and Aftercare.
The Key Village offers an introduction to TC concepts and processes, as well as a
discussion of the disease concept of substance abuse and other basic information
concerning health, emotional and cognitive issues (roughly 6 months). Crest continues
the emphasis on prosocial behaviors and adds elements preparing clients for their work
release and eventual re-entry into society, hopefblly to remain substance and crime free
(roughly 6 months). MerCare provides meetings and support for clients in work release
for another 6 months. Full treatment consists of an 18 month commitment by clients, and
clients can be dropped from the program for program violations ( physical violence or
threats of physical violence, drug or alcohol use, stealing or inappropriate sexual
behavior). Research demonstrates that length of time in treatment is inversely correlated
with rates of recidivism: put another way, the longer the treatment, the less likely a client
is to experience relapse.
In Delaware, the TCs have many different environments affecting them. Outside
influences range from the philosophy of the Department of Correction (DOC) to state
fbnding priorities to the physical fiicilities which house the TC programs. In order to
establish the context in which the TCs operate, let us briefly look at some of these
influences.
3
Philosophy of the DOC and TC Philosophy. The philosophy of the DOC is

0 generally a policy of incarceration and punishment, and the public is perceived as
generally supporting those views. The TC philosophy, on the other hand, is that of
habilitation; their view is that frequently substance abusers have not been given an
opportunity to learn prosocial behaviors, such as responsibility and accountability.
Within a safe and supportive environment provided by a TC: clients are given
information and support in their struggles to overcome substance abuse and criminality.
Because TCs operate within the prison system, frequent meetings and a M e r
understanding of the differing goals and pressures both TCs and the DOC face will
enhance the goals of both. A viewpoint focusing only on client habilitation might
underestimate the security and public safety issues confronting the DOC;conversely,
I
DOC pressures might cause prison officials and staff to not recognize the opportunities
created by TCs for habilitation and crime reduction, and to ignore or underestimate the
very real efforts made by clients in treatment. While there are fiequent interactions and
good working relationships between the wardens and TC directors at all the sites I
observed, I believe more opportunities to discuss pressure points and difliculties, in non-
crisis circumstances, would be helpfid. Such discussions might be helpll on a statewide
level as well.
‘
Facilities and Funding. All the facilities I observed appear to have serious
overcrowding as well as being understaffd. With regard to the TC programs, new
facilities at the BayIor Correctional Institution and in Dover will provide improved
a facilities. Facilities for women at the TC at the Sussex Correctional Institution need
substantive expansion as the overcrowding is significant and women are not allowed off
their tier generally. Crowding, coupled with the lack of movement or availab%ty of other
space, creates a very negative environment for clients.
Funding is an issue for DOC generally, as more funds are needed to adequately
house today’s prison population as well as prepare for &re need. More funds are
needed for women’s facilities in particular. Women’s needs have not been fbnded to
match their proportion of Delaware’s prison population: women represent approximately
6 % of the prison population, yet do not receive that level of funding. While the sheer
pressure of overcrowded male prisons seems oveiwhelmimg, we should not overlook the
importance of funding TC programs generally (because they are successll at reducing
recidivism) and especially for women (because of their importance in nurturing fbture
generations). Finally, I would recommend that a representative who is very
knowledgeabIe about women inmates be appointed to the M e d i d Review Committee
which apportions funds within DOC. Women’s unique needs cannot be adequately
addressed without representation by someone with expertise in women’s needs.
The new work-release center for women at Saylor is a critical new hdty that
will be operational in approximately 18 months. Separate work-release centers for men
and women are essential and the many individuals who worked to get this center funded
are to be congratulated on their successll efforts. The need for separate work-release
centers is so important that I recommend that the DOC take immediate steps to
4
provide separate facilities immediately, by creating work-release space at some

central location as an interim measure.
Although I will support this recommendation elsewhere in more detail, placing

women offendersin mixed-sex, work-release programs places them in a distracting,
psychologically damaging environment. Briefly, female offenders usually have suffered
serious domestic violence andor sexual abuse (estimates suggest that 80 to 95% women
prisoners are victims of domestic violence and/or abuse). At present, women in work-
release centers are significantly outnumbed by men, by a ratio of 7-1 or higher, and
frequently the encounter groups use hostile, contiontational styles as a means of
interaction. For female offenders, they are placed in an intimidating, counterproductive
environment which may mirror, to a frightening extent, earlier patterns of hostility and
intimidation by their abusers. For both men and women, unhealthy patterns of
interpersonal relationships may be facilitated by combined programs. While both men
and women must learn new healthier patterns of interpersonal relationships, work-release
centers are not the appropriate place; both women and men need to work on other issues
first, such as self esteem and other prosocial behaviors.
I also recommend that Gwen Empson, Director of the Key Village, be involved in
the design of the new facility so there is some representation fkom the TC programs as
TC clients will be assigned 30 the new facilities.
Community Semices. Although some jobs are available for work-release, more
community and business support would enhance the TC programs. Clients may find
positions, but lack transportation. Clients may also be eligible for aid fiom various
community and health service agencies, but may be “last on the list’, for services. It must
be very discouraging, to say the least, to work very hard on overcoming substance abuse,
only to find little support fkom the community. More efforts should be made to increase
job opportunities (and to increasejob skills training that is given within Crest and
Aftercare). For women and their children, more transition housing needs to be available
to assist their safe re-entry into the community.
VOP Centers. Although not a part of the TC program, VOP centers have been
used to house TC clients. I f a client is dropped fiom the TC program for serious
violations, temporary placement at a VOP center may be appropriate. But using the VOP
centers as temporary holding centers for TC clients should not be done. VOP centers
offer “hard time” to violators, and for TC clients, there is a disruption of their programs
because no training or fiunily interaction is provided. Habiditation is very intensive, hard
work, and such a disruption would seriously intedere with a client’s progress. Finally,
during my observations, I heard several TC clients say that they were told not to join the
TC because you could be sent to a VOP center and that would lengthen your prison time.
Whether or not this perception is valid, it is a serious concern among inmates, and could
deter them fiom joining the TC program. Program directors have also expressed concern
about the VOP centers and the lack of treatment provided to TC clients sent there.
5
II. Structure and Functioning of the TC Program
Before discussing each program element separately, I wish to note three pressure
points affecting the overall program.
Client Flow Through the TC Program. First, it is important to note that clients
flow through the TC program at Werent rates and from different starting points in the
system. Because of this, it is extraordinarily dficult to establish and maintain a
i
consistent therapeutic climate. For example, in an encounter group at Crest, you may
have, simultaneously, some clients directly sentenced into Crest with minimal
understanding of the TC community, "veterans" of the TC commuNty (those who have
been in the Key Village program for 6 months), and some clients repeating the program
(clients who may be back at Crest for a "tune-up"). Thus, at any given time, one has a
very diverse population in terms of their experiences in the program and their progress in
dealing with their substance abuse and criminality. This blend makes it very difficult to
provide and maintain a curriculum that meets clients' needs; counselors are in a very
diflicult position of dealing with individuals who are *dely divergent in terms of where
they are along the path to recovery.
My observations suggest that this blended population makes habilitation and

recovery for clients even more dZEcult. Given the variation in sentencing, and degrees
of substance abuse and criminality among clients, I do not know if this blend can be
altered or restructured. But, in my opinion, it would be help- to have conversations
among the TC directors and judges to discuss sentencing, who might benefit from TC
programs and who might not, and other related issues in order to strengthen the TC
program. Some have noted, for example, that drug dealers should not be sentenced to
TCs. It is important to note that research suggests that the longer the exposure to the TC
program, the lower the rates of recidivism. S t a in &et, have told me there is no such
thing as an effective "short" program (6 months or less) for substance abuse. Perhaps this
may lead to a reconsideration of the TC programs' operation: what clients are we most
able to help? While the answers to these questions may be ehsive, I believe the
questions are important to discuss, and would enhance the effectiveness of the TC
programs.
Client Selection and Treatment. An increasing number of TC clients, especially

women, have mental health problems. Some directors have estimated that as many as 20-
25% of clients have sigdicant mental health issues, above and beyond depression. In
addition, patterns of mental illness, substance abuse and criminality vary significantly
between men and women. At present, the TC programs are not equipped to handle such
clients. If such clients continue to be placed in TC programs, then TC programs must be
assigned or hire qualified counseiors to deal with mentally ill clients. Or the State of
Delaware must provide appropriate counseling and treatment.
6
This is a general problem fa& by DOC. There is only one psychologist to

diagnose, supervise and maintain clinical services in the state prisons. The demand for
such assistance far exceeds one person; each correctional facility should have its own
licensed clinical psychologist, and counselors trained in dealing with mental health
issues. Psychiatric service should be provided by a board certified psychiatrist. There is
a broad underlying issue here as to whether the Doc should handle mentally ill
individuals who have criminal records, or whether or not it is more appropriate to treat
such individuals elsewhere.
My recommendation is that TC directors be the final authority as to whether or

not clients are accepted into the TC programs. The directors, in conjunction with the
clinical supervisors, appear to be the best judges of who might benefit &om the TC
treatment.
The TC Structure. The TC programs in Delaware are based on a rational

authority model which is dependent upon a strict hierarchy and following a chain of
command. In actual practice, this means that (1) clients are placed in supervisory
positions over one another, and (2) clients are not able to directly access counselors on an
individual basis fie., one needs to go through the chain of command). There is also a
practice of placing clients in positions in the TC hierarchy which may make them
uncomfortable (e.g., a client who is quiet being placed in a position which requires him or
her to be an advocate for others).
Like most practices, the ones above can be exercised poorly with very negative
consequences or exercised we21 with very positive benefits. I believe the TC directors
and clinical supervisors should very caremy monitor how these practices are carried out.
An important part of the family climate and various job responsibilities is to teach clients
prosocial behaviors. In order to provide a safe environment, clients who exercise
authority over other clients MUST do so M y and without prejudice. If not, they must
be replaced. In no case should any client be placed in a position where he/she can harass
or abuse another client, nor should practices be permitted that allow clients to verbally
abuse one another. All house d e s and practices should be reviewed for their therapeutic
benefits: over time, some practices may have become managerial practices rather than
therapeutic practices. In my opinion, a fresh analysis of house rules and practices will
help enhance the program’s e f f d v a m .
TC practices also prohibit a client fiom speaking directly to staffunless they

follow the prescribed chain of command. While this may be necessary for a number of
reasons, there should be house rules describing the circumstances under which a client
may directly approach a counselor or staffmembex (e.g., a medical problem, personal
crisis, etc.). Clients whose job f u n ~ tisi to
~ ~act as an advocate or active listener may not
always understand, or adequately report, a potentially serious issue. It may take some
time to work out the details of direct access and circumstances under which it can be
done, but I strongly encourage this modification of TC practices in both Key Village and
Crest.
7
a Placing clients in job functions that might be uncomfortable for them should also
be carefilly monitored. In some cases, it may not create personal growth, but simply
increase the client’s level of stress and result in a job fbnction that is not being
appropriately carried out.
III. Gender Issues Affecting the TC Programs
Some general concerns about the TC program and its practices have already been
noted. In what follows, the discussion will consider the program in more detail and
focus on gender differences and their program implications. Comments regarding Key
Village and Crest will be combined because the program details are very similar.
Gender Differences. Gender differences among clients are consistently

identified by staff. Staffwho have worked with both male and female offenders agree
that women are more open, more supportive of one another and generally more actively
engaged in the therapeutic process. Those assessments were also born out in my
observations over the past six months: women were more attentive, more openly
supportive of one another, more readily expressed their feelings, and participated more in
groups than did men. While men tended to be confiontational with one another in an
aggressive, frequently hostile manner, women were confrontational but in a supportive
fashion (e.g., “You need to tighten up and get your act together because you need to get
home to take care of your babies. I know it hurts but you got to walk the talk.”)
a Women are perceived to be more expressive, but also more manipulative, while men are
viewed as more aggressive and less open.
Social science research also documents these gender differences. Women are
found to be more open and selfdisclosive than men. Women seek connections with
others through talk, while men ofien seek connections through activities, like playing
sports. Women tend to build on one another’s remarks whereas, men frequently ignore
or challenge others’ remarks. When interrupted or challenged by men, women tend to
remain silent (Haslett, Geis & Carter, 1992; Tannen, 1990). These communicative
differences suggest that women would likely benefit fiom, and do well in, a therapeutic
community that depends on collaboration and support fiom one another. In my
observations, it generally appeared that women seemed more genuinely involved in the
TC process. For example, while all clients are expected to “act as if” and give “patches,”
the actions and support given by women appeared more sincere and less “rote.”
Clients and their children. Children also appeared to play a bigger role in
female offenders’ lives than they did in male offenders. In well over 60 hours of
observations of different TC activities, only 3 men explicitly referred to their children
whereas roughly half the women did. Women frequently expressed concern over how
their children were doing, how they were being cared for, stress about cow proceedings
concerning custody, and other child concern. Children clearly played a major role in
motivating their struggle to overcome their addiction and remain crime fiee. Being able
a to provide more interaction with their children would clearly be a major incentive and
8
motivator for the women, and more contact would help the fknily’s stability. As noted in
Newsweek magazine (November 13,2000), “lost moms” are the fastest growing
population in prisons and they find it dif€icult to reconnect with their children. In 1999,
according to statistics collected by the U. S.Bureau of Justice, approximately 1.5 million
children had at least one parent in federal or state prison-an increase of almost 1/3 since
1990.
Domestic Violence and Abuse. The final gender difference I would like to
highlight is the background of domestic violence and/or sexual abuse for many female
offenders. Research documents that a very high percentage of female offenders have a
personal history of continued violence and abuse; staEat the various TC sites indicated
approximately 85-95% of female offenders experienced abuse. While men may have
been abused, their abuse stopped as they matured physically. The link between abuse
and/or severe neglect, and delinquency, has been identified in criminology for many
years and, according to study the National Institute of Justice (1996), “there seems to be
little difference in child is abused or neglected in this pattern of consequent delinquency”
(Pollock, 1998, p. 96). Included in this consequent pattern of delinquency would be drug
usage and addiction, leading to crime and subsequent incarceration. In addition, recent
studies indicate that early childhood abuse (and its trauma) may alter the finctioning of
thbe brain and lead to subsequent difficulty in establishing relationships with others.
While abuse is an important issue fQrboth men and women, it is a critical

treatment issue for women. The TC environment is to “provide a safk environment” in
which to learn prosocial behaviors and remain substance and crime fiee. However, in the
Crest facilities, men and women participate in mixed sex groups throughout their time at
Crest. As mentioned earlier, neither men nor women need the distractions provided by a
heterosexual environment. But the TC program and staE, I believe, have overlooked the
degree to which the encounter groups and the TC hierarchy may inadvertently create an
environment of male dominance associated with earlier patterns of abuse. The
confiontational strategies used in the programs, often verbally aggressive and hostiie, as
well as the overwhelming number of males in the Crest program (better than a 7-1 ratio
of men to women) and their predominance in the TC hierarchy, combine to form a
psychologically threatening environment for women, which may mirror earlier abusive
situations (e-g., angry, hostile men). Habilitation is a very difficult process without the
added stress in the Crest environment. For these reasons, I believe the Crest program
should be a same sex program as is the Key program. Some educational
programming could be coed, but the basic finctioning of the TC houses and groups
should be Same sex grouping. Until the new facilities are completed, perhaps trailers or
some other space can serve as an interim fkcility. In addition, given the prevalence of
violence and/or sexual abuse for female offenders, the stafftreating female offenders
should also be women. It may be very problematic for female offenders to develop a
high level of trust with male counselors, and many may not be comfortable discussing
issues of sexual abuse with male counselors.
Medical Concerns and Patterns of Abuse. Differences between men and

women offenders in terms of type and pattern of substance abuse have been weN
9
documented. The issue of potysubstance abuse is also well known. In addition,the

0 greater numbers of female offenders experiencing mend health problems (Le., dual
diagnosis) has also been documented. In general, these issues are not being adequately
addressed within the penal system. Staff and counselors do not have the appropriate
training to cope with the increasing number of mental health issues presented by clients,
and, as noted earlier, psychological and psychiatrk services are very limited. These
issues need to be addressed by more support and training if habitation is to be
successll; such services may be provided by the state or the contracting agency, such as
Spectrum Behavioral Services.
The TC program structure discusses the disease concept of substance abuse,

relapse triggers, the criminal mind, the p r q s of addiction and other general concepts,
but does not appear to adapt program information to specific clients (e.g., talking about
female patterns of addiction with women, male patterns with men,etc.). While directors
are knowledgeable about these issues, it is less clear that counselors are aware of these
differences. However, some of these differences may be addressed in the individual
treatment plans, which were not available to me.
IV. Gender Appropriateness of the TC Program
The treatment components in the TC program include behavioral, cognitive and

emotional aspects. Of these three elements, the behavioral aspect appears to be the most
0 heavily emphasized. Although a behavioral emphasis is needed at the beginning of the .
program, as incoming clients ‘‘kam’’ the system, it should become less important over the
duration of the program. The cognitive and emotional aspects need to become more
prominent because it is these two components that will allow the client to remain free of
crime and substance abuse.
In the program literature, the concept of ‘‘rational authority” is used, but never
clearly articulated. In my view, that concept is very elusive, and not very helpll in
explaining the TC structure and rules. It seems more appropriate to use the metaphor of
the “family,” where there is an authority system, various “job”functions,and rewards/
punishments. This would also seem appropriate given the TC’s focus on habilitation, and
also make most sense to the clients. I recommend that the rational authority language be
dropped from program materials, and the fitmily metaphor be used instead. The most
effective TCs I observed strongly emphasized the f d y metaphor, and clients referred to
each other as family members.
Many clients are experiencing sigmflcant personal change. The use of Lewin’s
force field is quite useful in helping clients understand and cope with change. The day-
to-day changes and upheavals experienced in the program can also be usellly explained
d with
by Lewin‘s concept. Generally, it appeared that both clients and s t ~ c o p e well
day-to-day Changes.
10
With this general overview, we next turn to a more specific assessment of the TC
program.
The TC Structure. The three phases of therapeutic treatment, ‘KeyVillage, Crest

and After Care, move clients through a structured treatment process. Key Village
primarily introduces the TC structure and process, and Crest continues the educational
process of habilitation, as well as prepares clients for transition to society. M e r Care
provides group and counseling support for clients working in the community. A
shortened TC program consists of direct sentencing into Crest and then moving onto
After Care. Although research data on the TC program found that the longer the I
exposure to the program, the lower the rate of recidivism for both men and women, the
shortened program @st Crest and M e r Care) does no better than incarceration itselfin
reducing recidivism.
Key Village and Crest. These two phases are the primary treatment phases with
After Care providing continued support for clients working in the community. Under the
guidance of Director Gwen Empson, the Key Village program at BWCI has already
modified the TC program to make it more appropriate for women. However, to
maximize the effectiveness of the TC program for women, the cumculum needs more
modification, and the Crest programs need to be provided in a same-sex environment.
More specific comments about the programs are outlined below.
A. House hierarchy. The job lknctions and hierarchy appears to be usefid for
the purposes of teaching, monitoring and maintaining prosocial behaviors.
However, each job fhction should be reviewed for its therapeutic as well as
“house management” usefblness. As noted earlier, clients with positions in
the house hierarchy must be carefblly monitored by staff so that there is no
abuse of a position’s authority. The general chain of command should be
modified so there is a recognized procedure for clients to have direct access to
st&. Clients in “gatekeeping” positions may not always exercise good
judgment in limiting access or in identifiing problems.
B, Orientation Phase. The orientation materials provided seem clear. The new
orientation materials written by Director Empson were well done and covered
the educational issues in greater detail. As noted earlier, I would recommend
an increased emphasis on the family metaphor for the program generally, but
especially for women. There is a significant amount of procedure for clients
to leam, and having house positions devoted to orientation seems to be very
helpfid.
C. Encounter Groups. The encounter groups play a significant role in helping

clients adapt to their new social environment, dealing not only with client
behaviors, but also identifjing negative attitudes and denial. Several changes
in the encounter groups, however, would make them more effective:
11
1. Encounter group size needs to be reduced. In the Key program at

Gander H l l , for example, I observed encounter groups of 40-60 clients. I
observed very few clients paying attention, and the noise level made it
very difficult to hear what was going on (even though clients were
shouting as they gave indictments). I recommend that the two groups of
60 be m h e r divided into g r ~ p of
s twenty clients each, with each group
having a counselor with them. This increases client involvement because
a client’s inattention can be more easily noted. At Crest South, Jim Elder
has been experimenting with smaller groups and has found this to be more
effectivefor both staff and clients. At Key Village, with the new pods of
approximately 24 clients each, encounter group size is at a good number.
In general, an encounter group S i much over 20 greatly decreases its
effectiveness just because increasing group size decreases group members’
involvement.
2. A number of dBerent communication strategies have been identified

for clients to use in encounter groups. The most fkquently used strategy
is one of hostility. The orientation manual describes this as a venting of
feeling, and notes that early groups may run almost entirely by hostility.
In most encounter groups I observed, hostility was the predominant
strategy used. At Key Village, when hostility was used, it was a more
softened, constructive form of anger that was being expressed. My
concern is that hostility? particularly the forcefil, aggressive in-your-face
style used in the TC community, is very non-productive. Such a style
expresses anger, but does not offer the client or other listeners a
constructive way to cope with the anger. It is also a technique that is risky
when used in society at large. I believe that clients should be taught a
sequence of strategies and expected to use each one. There are more
constructive ways of expressing emotion and anger, and clients should
appreciate and use them also
Director fim Elder has been experimenting with two types of
encounter groups: one session uses the usual tactics of hostility and in the
other session, clients must use other strategies. Clients refer to this
alternate session, interestingly, as the “love” encounter. But requiring
clients to use a variety of strategies in dealing with others is very
important. The use of the verbally aggressive hostile strategy is
inappropriate with female offenders because of its intimidation and
mirroring of past experiences of abdintimidation.
3. During the encounter groups, negative emotions and feelings are

directed at others. In the EG structure, clients are charged with displaying
negative behaviors and attitudes, but given no opportunity to respond
other than by a “thank you for this life-saving information.” I recommend
that some opportunity be provided for interaction between clients, ifboth
clients agree to this. Just venting and then moving beyond may not always
12
be an effective option. Counselors should be monitoring EG interactions

to offer these opportunities when this might be usefbl.
4. In general, TC communities operate under a rule of “no dialogue” or

minimum dialogue. This seems to be arbitrary and unhe1pfi.d. It is with
daily interaction that clients might provide helphl support to one another
or engage in general conversation. This would provide more opportunities
to leam prosocial behaviors.
Environment. The Key Village environment at BWCI reflects the use of color
and positive signs to encourage clients. Clients are able to have some room decoration
(like curtains) and can wear their own clothing (rather than uniforms). Personal clothing
is also worn at Crest facilities. I believe color and clothing choice enhance the
environment and are really appreciated by clients. During the holiday season, Key
Village pods had made decorations that made the rooms more welcoming.
The women’s areas appeared to have more posters, signs and other messages than
did the men’s areas. Interestingly, the type of messages also di&red with women’s
messages generally being more positive and supportive whereas the men’s tended to be
more negative in tone, with negative consequences emphasized.
There is a need for more private space (for counseling sessions, intake interviews
and assessments, etc.) and for a larger public space in all the Eicilities. Gander Hill has a
large group space, but did not offer any private settings for client/counselor sessions.
The Crest South program needs more space for female offenders, who have
limited space and virtually no opportunity for movement off their tier. And at the Key
Village, some access to a larger group space needs to be given. With some creative
thinking and scheduling, perhaps the available spaces could be more effectively utilized.
Curriculum. The curriculum, in general, offied by the TC communityyappears

sound and covers important issues. The Key Village curriculum has been modified
appropriately for women in that there is reflection time built into the schedule, and there
are offerings in stress management and spiritUaIity. The reflection and spirituality
dimensions are especially important for women because they often nurture others (both
their own and societal expectations) but fiequently neglect their own nurturance. This is
well substantiated in the social science research literature.
The information on the disease concept, addiction, the Criminalmind, etc. seem to
be fairly standard across the TCs. It would be helpll to modi@ these elements so they
are tailored more specifically for each sex (and when the Crest phase becomes separate
, for men and women, this should be more easily done). Patterns of substance abuse and
criminality vary as a fbnction of sex ofthe offender, and that information needs to be the
standard information presented to clients. Two directors, Jim Elder and Gwen Empson,
also emphasized getting a GED as a minimum for their clients.
a Each TC cite has several volumes of curricular materials (e.g., currkulum outlines
for various life skills, addiction, the disease concept, etc.). However, these materials
usually had to be borrowed (only one or few copies were available) and ,thematerials I
looked at were dated (most references from the 1970s, 1980s or early 1990s). I believe
the resource materials available to counselors needs to be updated and strengthened.
In addition to materials being substantially upgraded, new areas of information
need to be provided for women (and, when appropriate, for men). For women, there
should be materials covered in an introductory psychology of women course (e.g., self-
esteem issues, sexual abuse, systemic discrimination, patriarchy, etc.) Such materials
need to be tailored for each audience, and would provide an overall framework for
integrating all the program information (Le., information about patterns of criminality,
i
job training, life skills, and so forth). At present, there is NO integrating fiamework for
the TC materials and such a course would provide it (thus enhancing retention and
understanding of the material). More needs to be done on self-esteemand women’s
health issues.
For both women and men, much more needs to be done on anger and anger
management. This also needs to be tailored specifically for each sex, because women
internalize anger (self-blame and lowered self-esteem) while men externalize anger
(blame others and express violencehostdity toward others). Anger produces stress and
the emphasis needs to be more on handling anger, rather than stress. Both men and
women need more discussion of healthy relationships, both within the family and more
generally within the community.
e ’
- and basic
Another area to expand for both men and women is vocational training
job skills (like interviewing, appropriate dress, and so forth).
One final general observation is that the curriculum does not seem to be well-
sequenced; that is, the curriculum appears to be a series of separate topics, rather than
building upon what has been learned previously. Some of this may be dif€icult,
especially in Crest with some clients coming in via direct court sentencing. But more
coordination between Key programs and Crest programs would be helpll. Some clients,
in hct, mentioned to me that “the material gets old,” so even clients are noting the
repetitive information and the lack of new information which builds upon knowledge
clients have already acquired. While some materials may need to be repeated, they should
be presented in a difFerent framework or new perspective so that clients continue to
benefit. Added vocationd training, as well as basic home repair, could be added to Crest
programs.
Some classes, such as the parenting classes, draw on outside programs and
agencies. More effort might be made to have experts in different areas give presentations
on various topics; these presentations could be videotaped and the material shared with
other sites. These materials would supplement other programs such as Project Reconnect
and the Read Aloud Institute. Materials, such as videotapes on special topics, also need
to be more available to both W a n d clients.
14
After Care. The Mer Care program consists of supporting clients as they re-
enter society and look for employment. Some clients have mentors in the community,
and the mentor program seems to be a very valuable aspect of support. The required
meetings and one-on-one counseling sessions appear to be very useM. Some effort has
been made to try to get peer groups started outside the TC community, but those have not
yet been successll.
It is during After Care where serious lack of support creates substantial problems
that undercut the entire habilitation program. Clients have made very serious attempts to
become substance fi-ee, yet as a society, and through our state agencies, we fail to offer
work opportunities and support to assist them in making a living wage. With our lack of
support, we make an already difficult re-entry even more dif%cult.
My discussions with varied DOC officials and TC staffpointed out many

shortcomings. First, there is little job training available. More training needs to be
offered in “non-traditional” areas, such as construction for women, and job skills, such as
punctuality, courtesy and the like, must also be taught. Much of what we assume is part
of everyday knowledge has not been learned by clients. Second, state social agencies,
already overwhelmed by demands, often put “ex-cons” last on the list to be helped. In
part, it may reflect their lack of training in how to handle this population, as well as
negative perceptions about drug offenders. The state lacks transition housing generally,
and there are very few transition houses for women and their children. Transitional
housing should be available in every county. This need is particularly urgent for women
since they are often caring for children and lack the social support network men may
have @e.,the men may have wives or significant others to support them-women often
provide such support networks for men).
Parole and probation officers should be housed at every correctional facility in

order to make it easier for clients to meet with their probatiodparole officers.
Transportation may be difficult for clients, and having a central location would be
helpful. With Delaware’s zero tolerance policy, offenders might be in violation simply
because they cannot get to their probation officers.
V. Staffing the TC Program
Much of the success of any program depends upon the staffwho deliver the
program-the directors, clinicians and counselors in TC programs. The dedication of the
TC staff is impressive, as is their ability to cope with the high level of daily change and
the challenge of the program.
Many staffers in the TC program are themselves recovering addicts, so they know
personally the challenges and difficulties of substance abuse. This is positive when
dealing with clients because staffers “know” when clients are in denial, not confronting
their addiction, failing to put forth genuine effort, and so forth. All are working on their
certification, or maintaining their certification as drug and substance abuse counselors.
a However, other staffers need to be hired with degrees in counseling, social service
work, psychology, mental health special education and/or education. w e the current
staff can readily identi@"where a client is at," they may lack the expertise to assist
clients in gaining firrther knowledge or insight. Such a "blended" staffwould learn from
each other, and provide an enhanced program of treatment to clients. In particular, more
staffwith expertise in mental health issues needs to be hired ifTC programs are to
include clients needing such services.
/
Not surprisingly, staffturnover is high, with Delaware's turnover rate i
(approximately 50%) exceeding the national turnover rate (approximately 40%).
Although turnover rates may be due to a number of fiictors, one factor probably is the
difficultyof getting the necessary training for re-certification. This is a responsibility for
both the state and Spectrum Behavioral Services (SBS). The state, for example, does not
give training for r e - d c a t i o n . SBSprovides very limited f k d s for trahhg. While
ATTC provides training, it provides training available for state agencies, and TC staffers
may be ccbumped"by other agency &IE Each director has to share limited training
opportunities across their st&. More benefits and better salaries would also help reduce
the high turnover rate.
I recommend that the state offer training and course work that can count toward
re-certification. SBS needs to provide more h d s for training, and offer more h c i a l
incentives for its staff For example, if SBS offers to pay for training, it could require
e staffers to work for a certain number of years in exchange (as many private companies
already do). The TC program already demands a great deal &om its s ta and the @, in
turn, needs to have more training support. This is clearly an affordable "win-win"
situation which will considerably enhance the TC program.
Finally, staff would benefit fiom having more computer support. With very
minimal investment, computers could be provided for counselors to process case
information more efficiently and to keep more accurate records, In particular, low COS^
voice recognition equipment could be integrated in the computers so that counselors
could record their case notes immediately after a client interview, and then later check a
prhtout of their notes for accuracy and completeness. This will cut down on
"paperwork" significantly, allow counselors to spend more time with clients, and enhance
staff morale. The computers could be networked so client information could be easily
shared with the director and other &.
I hope this overview of the TC program, with an eye towards its gender
appropriateness, will be helpfbl in modifjing treatment. It has been a pleasure to
participate in this grant, and I hope the observations and recommendations contained in
this report will help strengthen the TC program.
16
References
Haslett, B., &is, F. L., & Carter, M. (1992). The org;anizational woman: Power and
Paradox. Norwood, N3: Ablex.
National €nstitute of Justice. (1996). The cvcle of violence revisited (Research brief).
Washington, DC: Government Printing Office.
Pollock, J. (1998). Counseling women in prison. Thousand Oaks, CA: Sage. I

Tannen, D. (1990). You just don’t understand. New York: MOKOW.
STATE OF DELAWARE
EXECUTIVE DEPARTMENT
CRIMINAL JUSTICECOUNCIL
-
STATE OFFICE BUILDING TENTH FLOOR
820 FRENCH STREET
WILMINGTON, DELAWARE 19801 TELEPHONE: (302)577-5030
FAX:(302)577-3440
Informed Consent Form for

Investigating Gender Appropriate Corrections
Based on Drug Treatment in Delaware:
An Exploration of the Village / Crest Aftercare
Therapeutic Community Drug Treatment Continuum
Program Participant Interview
The Delaware Criminal Justice Council is a state agency that conducts research on
criminal justice programs. You are being asked to participate in a study regarding the therapeutic
0 community drug treatment model to see if it works for women.
The interview you are being asked to participate in will last for about 45 minutes and will
be audio taped. The audio tape will be destroyed after completion of the evaluation of the
program.
The researchers will not release or make available any comments you make to the
program staff or inmates. The comments that you make will only be used by or revealed to those
conducting the research. Participation in this interview is voluntary and there are no risks to you
if you decide not to participate in this interview. You also have the right to stop participating in
the interview at any time at no risk to you.
Federal regulations give you the right to contact the principal investigator for this research
if you have any questions in regard to this evaluation. The principal investigator is Arthur H.
Garrison. If you have any questions in regard to this evaluation, you can write Mr. Garrison at the
following address:
Arthur H. Garrison
State Office Bldg. 1 O* Floor
i
820 N. French Street
Wilmington, De 19801
'
If you have any questions in regard to your rights as a participant in this interview you may
contact the human Subjects protection contact who is Dr. Marsha Miller. If you have any
questions in regard to your rights as a participant in this interview you can write Dr. Miller at the
following address:
Dr. Marsha Miller

Human Subjects Protection Contact
c/o
Arthur H. Garrison
State Office Bldg. lofhFloor
820 N. French Street
Wilmington, De 19801
Do you wish to participate?

By signing your name you agree to participate in this interview.
Please sign both copies of this form. The interviewer will give you one copy to keep.
STATE OF DELAWARE
EXECUTIVE DEPARTMENT
CRIMINAL
JUSTICECOUNCIL
-
STATE OFFICE BUILDING TENTH FLOOR
820 FRENCH STREET
WILMINGTON, DELAWARE 19801 TELEPHONE: (302)577-5030
FAX: (302)577-3440
Informed Consent Form for

Investigating Gender Appropriate Corrections
Based on Drug Treatment in Delaware:
A Proposed Exploration of the Village / Crest Aftercare
Therapeutic Community Drug Treatment Continuum
Focus Group Participant
The Delaware Criminal Justice Council is a state agency that conducts research on criminal
justice programs. You are being asked to participate in a study regrading the therapeutic community
drug treatment model to see if it works for women.
e The focus group you are being asked to participate in will last for about 1 hour and will
include some of the other women in the program with you. The focus group will be an open
discussion about the drug treatment program. The focus group discussion will be audio taped. The
audio tape will be destroyed afler completion of the evaluation of the program.
The researchers will not release or make available any comments that you make to the
program staff. The comments that you make will only be used by or revealed to those conductingthe
research. Participation in this focus group is voluntary and there are no risks to you if you decide not
to participate in this focus group. You also have the right to stop participating in the focus group at
any time at no risk to you.
Federal regulations give you the right to contact the principal investigator for this research if
you have any questions in regard to this evaluation. The principal investigator is Arthur H. Garrison
-
at 302 - 577 8728. If you have any questions in regard to your rights as a participant in this focus
-
group you may contact Dr. Marsha Miller at 302 - 478 8912. Procedures have been established to
allow you to exercise the right to contact either Mr. Garrison or Dr. Miller.
By signing your name you agree to participate in this focus group.
Please sign both copies of this form. The focus group leaders will give you one copy to keep.
' Date
e
Time: (Started)
Interviewer (to be read as written): My name is Dorothy Lockwood and this is Alison Rose.
We work with the Delaware Criminal Justice Council. The Delaware Criminal Justice Council is
conducting a study to determine if the therapeutic community treatment program here at Baylor is
meeting women’s needs. Originally, the program was designed for males and now that it is being
implemented with women we want to know if its being implemented keeping in mind the special
issues and needs women have. Part of the study of the therapeutic community treatment program
involves conducting interviews of the women who are currently in the program. I hope to
conduct an interview with you to get your views about the program. Alison is here to assist me
and take notes on the interview.
Before we begin I want to make sure that you understand that you have the right not to participate
in this study and you have the right to stop participating in the interview at any time without any
consequences to you. What you say will be confidential and none of the information that you
provide will be identified to you personally. In other words nothing you will say will be
connected to your name.
a This interview should take about 45 minutes to an hour and is being audio taped. The interview
is being audio taped in order to accurately and completely gather information fiom the interview.
The tape will be held in secure place within the Criminal Justice Council and only those who are
involved in the evaluation will have access to them. None of the treatment staff or staff form the
Department of Corrections will have access to the tapes. Upon completion of the evaluation that
tapes will be destroyed.
If you agree to participate in this evaluation, please review the informed consent form. The form
puts in writing what I have just told you. The Principal Investigator of this evaluation is Arthur
H. Garrison at the Delaware Criminal Justice Council. The human subjects protection contact for
this evaluation is Dr. Marsha Miller. Federal regulations gives you the right to contact Mr.
Garrison in regard to questions you may have about the nature of the evaluation. You also have
the right to contact Dr. Miller in regard to questions about your participation in this interview.
If you have any questions and or concerns in regard to this evaluation, you may send those
questions or concerns to the following address: Arthur H. Garrison, Delaware Criminal Justice
Council, State Office Bldg. 1 0 Floor,
~ 820 N. French Street, Wilmington, De 19801. Any
concerns or questions that you have in regard to your participation in this interview are to sent to
Mr. Garrison who will forward them Dr. Miller for her response to your concerns. The signed
consent form, which you will receive fiom me, provides the address for Mr. Garrison.
Please review the informed consent. (Wait, watch interviewee read form)
0
Page 1 of23
(If yes) Please sign the second page. (Interviewer sigh in appropriate place).
(If signed).
O K , thank you for agreeing to participate in this evaluation. I will be asking you a series of
-
questions. Some of them are yes no types questions. Others are questions in which I will be
asking for your opinions. Please feel free to answer as completely as you wish. The questions
will center around how the program is designed, implemented and your opinions about the
quality of the program. Some questions will be of a personal nature in regard to your drug use
history and other types of personal information. As I said before, all answers you give will be
confidential and only reviewed by those involved in conducting the evaluation. But you have the
full right to refuse to answer any particular question.
Do you have any questions? (Interviewer, answer any given).
O.K., let’s begin.
Page 2 of 23
Notes for
Interview Questions
1. Basics
Name:
Age: i
Race:
Time in program (months):
Offense:
2. Questions dealing with prior drug use:
1. Have you been in drug / alcohol treatment before?
Yes No (Circle One)
If so, how many times have you participated in treatment?
2. How long were in each of the treatment programs that you participated in?
3. Did you ever participate in the village program before now?
Yes No (Circle One)
Page 3 of 23
If so, how many times did you participate in the village program before now?
If so, how long did you participate in the village program before now?
3. Questions dealing with the first four weeks (orientation)
1. Did you find the orientation phase a difficult adjustment for you?
Yes No (Circle One)
2. If yes, it what ways was it difficult
If no, how would you characterize it
Page 4 of 23
3. Do you think the orientation phase should be longer?
Yes No (Circle One)
If yes, how much longer
If no, why not
4. What changes, if any, would you make to the orientation phase?
Page 5 of 23
5. Did the program get harder or easier as you went through it?
Harder Easier (Circle One)
It what ways?
4. Questions dealing with confrontation aspects of the program
1. How do you feel about the confiontational aspects of the program?
2. Do you feel this is appropriate for females?
Yes No (Circle One)
Why?
Page 6 of 23
3. Has the confrontational aspect of the program helped you? I
Yes No (Circleone)
WhY
4. Are you able to address issues you have with family members on a one-on-one
basis, or do you have to go through the hierarchical channels?
5. How useful was the hierarchical system in your treatment process?
Page 7 of 23
6. Is it appropriate for family members to have a role in the hierarchical structure of
the house? Yes No (Circle One)
Why:
7. Have family members abused their authority in the hierarchical structure?
Yes No (Circle One)
If yes, How and how often?
8. How has your position of authority in the hierarchical structure improved your
treatment in the program? Yes No (Circle One)
Why:
Page 8 of 23
5. Questions dealing with sanctions and program rules
1. Do you feel that the program rules are appropriate?
Yes No (Circleone)
Why I why not?
2. Do you think that the program rules help with the treatment process?
Yes No (Circle One)
Why
Page 9 of 23
3. Do you feel that the program sanctions are appropriate?
I
Yes No (Circle One)
WhY
4. Do you think that the program sanctions help with the treatment process?
Yes No (Circleone)
MY
5. Do you think it is appropriate for another family member to impose sanctions?
Yes No (Circle One)
Why / why not?
Page 10 of 23
6. Questions dealing with staff / participant interaction
1. Do you feel there needs to be an increase or a decrease in the individual sessions?
Increase Decrease (Circle One)
Why?
2. Did you find these individual sessions helpfid in your treatment?
Yes No (Circle One)
Why
3. Do you feel there needs to be a increase or decrease in the group sessions?
Increase Decrease (Circle One)
Why?
Page 1 1 of23
4. Did you find these group sessions helpful in your treatment?
Yes No (Circleone)
%Y
5. Do you feel there needs to be an increase or a decrease in the peer group sessions?
Increase Decrease(Circ1e One)
6. Did you find these peer group sessions helpful in your treatment?
Yes No (Circleone)
WhY
Page 12 of 23
7. Questions dealing with program activities (responsibilities) as opposed to general
population
1. Before entering the Key Village program this time, how many months did you
spend in general population? ,
2. Over your lifetime, how many times have been in prison?
3. Which was harder, the daily schedule of general population or the daily schedule
of the program?
General population Program (Circle One)
How and Why?
4. How did your responsibilities change when you left general population and
entered the program?
Page 13 of 23
8. Questions dealing with being ready of change
1. What did you expect to get out of participating in the Village program before you
entered it?
2. How did you feel about coming in to the program?
3. How have your expectations changed, if at all?
Page 14 of 23
4. Why did you stay with the program?
I
9. Questions dealing with supports systems
1. Who, outside of the program, have been supportive of you while you have been in
the program?
2. Are you aware of support services that are available to you after your release from
the program?
Page 15 of 23
3. What are some of the support services that you think you will need after your
release fiom the program?
4. Within the program, who has been most supportive to you while you have been in
the program. This can include counselors, peers, ect.
10. Questions about children visits / children as a motivation
1. Do you have children? Yes No (Circleone)
How old are they?
If yes go through questions 2 - 5 if not move on to next grouping of questions.
2. Did having your children visit help motivate you to stay in the program?
Yes No (Circleone)
3. How do you feel about having children visit in the program?
Page 16 of 23
4. How does having children affect you while in the program?
~~ ~
5. How worried are you about your children?
11. Questions dealing with physical aspects of the program
1. What do you think of the physical facility (space) of the program?
Page 17 of 23
2. What do you think about having a 24 family member pod as compared to a 42
member pod?
i
3. Do you feel you have enough privacy in the facility?
4. Do you feel you have more privacy than in general population?
Page 18 of 23
5. What changes would you make to the physical environment?
12. Questions dealing with mental health
1. Do you find that you feel depressed a lot of the time?
Yes No (Circle One)
If so, what types of things make you feel depressed?
2. Has being in the program helped you deal with feelings of depression?
Yes No (Circleone)
Why:
Page 19 of 23
3. Do you find that you feel anxious a lot of the time?
Yes No (Circleone)
If so, what types of things make you feel anxious?
4. Has being in the program helped you deal with feelings of anxiety?
Yes No (Circle One)
Why:
5. Do you find that you feel angry a lot of the time?
Yes no (Circleone)
Why: What types of things make you feel angry?
Page 20 of 23
6. Has being in the program helped you deal with feelings of anger?
7. Have you ever had a mental health diagnosis?
Yes No (Circleone)
If so, what was the diagnosis?
14. Do you feel there is a need for additional vocational and educational training or services
to assist in your continued drug free lifestyle when you leave the program?
Yes No (Circle One)
If so, What kinds
Page 21 of 23
15. What do you feel is the single most important aspect of your treatment?
~~~~~ ~ ~
16. What was the most significant experience you had while in the Key Village program?
17. What was the most valuable tool you will be able to take with you from the village?
Page 22 of 23
18. Do you think the tools in interacting with others that you have learned in the program will
help you deal effectively with others when you leave the program?
,
19. How would you amend the Key Village Program? What would you add, remove, or
change?
Time: (Ended)
Page 23 of 23

Date Received: August 8, 2002

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The author(s) shown below used Federal funds provided by the U.S.

Department of Justice and prepared the following final report:

Document Title: Process Evaluation Assessing the Gender

Author(s): Delaware Criminal Justice Council

Document No.: 195788

Date Received: August 8, 2002

Award Number: 1999-RT-VX-K016

Opinions or points of view expressed are those

Dorothy Lockwood - Dillard, Ph.D.

Beth Haslett, Ph.D.

This report was written by:

a States Department of Justice.

Part Two: Curn'culumReview...................................................................... 31

Part Three: Assess Client SatisfBction............................................................. 38

Part Four: Focus Group Analysis................................................................... 41

Baylor Women's Correctional Institute................................................... 42

Analysis and Discussion ............................................................................................................... 49

Appendix Two: Haslett. B.(2001).EVALUATION OF THE GENDER

Appendix Three: BAYLOR INTERVIEW SURVEY AND IRB

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

The evaluation was divided into four parts:

Part One: Assess recent graduates of Baylor as a basis to create a profile of

Part Two: C u r r i c b review.

Report to the National Institute of Justice Delaware Criminal Justice Council

1. A review should be conducted on how people are placed in CREST North

3. An assessment is needed to determine what actually needs to change to

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

B h e points out that there are basic

Report to the National Institute of Justice Delaware Criminal Justice Council

a Process Evaluation Assessing the Gender

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

In January 1994 a forty-two-bed TC program was instituted at Baylor through a grant

Part Two: Curriculum review.

Part Three: Assess client satisfaction.

Part Four: Focus group analysis.

Report to the National Institute of Justice Delaware Criminal Justice Council

(2) Assessment of the level of gender appropriateness of the TC program components

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

e Process Evaluation Assessing the Gender

21 to 29 years old 14 13.6

Part Two: Curriculum review.

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

a Process Evaluation Assessing the Gender

a Process Evaluation Assessing the Gender

Part Three: Assess client satisfaction

Part Four: Focus group analysis

Baylor Women’s Correctional Institute

Report to the National Institute of Justice Delaware Criminal Justice Council

e Process Evaluation Assessing the Gender

Report to the National Institute of Justice Delaware Criminal Justice Council

Report to the National Institute of Justice Delaware Criminal Justice Council

a the use of the therapeutic milieu (i.,e., treatment group) to

Report to the National Institute of Justice Delaware Criminal Justice Council